#2-51E. Rethinking Status Quo Bias: How Multiple Alternatives Nudge PCP Decisions (JAMA Netw Open, 2025)

Unwarranted health care variation, particularly in areas like opioid prescribing, challenges quality and patient safety, necessitating effective decision support tools. This randomized clinical trial addressed whether the number of suggested alternatives affects primary care physicians’ (PCPs) decision-making. Researchers presented 402 PCPs with clinical scenarios and compared groups offered only one alternative versus those offered two or more appropriate alternatives. The most critical finding is that offering two or more appropriate alternatives significantly increased the odds of PCPs choosing an alternative over the status-quo plan (adjusted OR 1.90). This finding directly challenges prior influential studies suggesting a status-quo bias when physicians face multiple options. This evidence is crucial for physicians, as leveraging multiple appropriate options in alerts could significantly improve adherence to preferred care and reduce unwarranted variation. However, it is essential to critically note that the design utilized online vignette surveys, which inherently limit the full replication of complex, real-world clinical decision-making.

Citation: Altinger G, Maher CG, Jones CMP, et al. Multiple Suggested Care Alternatives and Decision-Making of Primary Care Physicians A Randomized Clinical Trial. JAMA Network Open. 2025. DOI: 10.1001/jamanetworkopen.2025.42949

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.