Patients often exhibit hostage-like behaviors when dealing with their medical caregivers – underplaying serious symptoms, reluctant to ask questions, and fearful to express concerns about treatments – says Leonard Berry, a marketing professor from Mays Business School at Texas A&M University.

The trend is so prevalent, Berry and his three co-authors titled their paper in the September 2017 issue of Mayo Clinic Proceedings: “When Patients and Their Families Feel Like Hostages to Health Care.”

“Patients and families often hold back from openly engaging clinicians in the thorough discussions that true shared decision making requires,” Berry explains. “We refer to this phenomenon as ‘hostage bargaining syndrome’ (HBS) because, in the presence of clinicians, patients and their families may behave like hostages negotiating, from a position of fear and confusion, for their health.”

HBS is most likely to occur in cases of serious illness.

Clinicians are unlikely to want their patients to feel like hostages, and many will actively encourage the patient’s involvement in shared decision-making. They encourage respect and collaboration in health-care scenarios.

In a video of Berry, he describes the phenomenon of HBS, offers clinical vignettes to clinicians to assist them with identifying it, and emphasizes the value of fostering shared decision-making with patients in their care.

Berry is a Regents’ Professor at Texas A&M University, a Senior Fellow at the Institute for Healthcare Improvement, and a University Distinguished Professor of Marketing at Texas A&M.

Berry is the lead author of the paper. His co-authors are Tracey S. Danaher, a marketing professor at Monash University in Melbourne, Australia; Dan Beckham, president of The Beckham Company; Dr. Rana L.A. Awdish, director of the Pulmonary Hypertension Program and medical director of Care Experience at the Henry Ford Health System in Detroit; and Dr. Kedar S. Mate, senior vice president of the Institute for Healthcare Improvement in Cambridge, Mass.