Game Theory Perspectives on Physician-Patient Interaction and Relational Lock-in

Abstract

Path dependence in clinical decision-making manifests not only through cognitive biases and institutional structures but also through strategic interactions between physicians and patients. This article examines the relational dimension of path dependence through game theory frameworks, analyzing how repeated clinical encounters create self-reinforcing equilibrium states that become resistant to change. We identify three key mechanisms: signaling games during initial encounters that establish interaction patterns, the evolution of cooperation norms in long-term relationships, and relationship-specific investments that create switching costs for both parties. The analysis reveals how incomplete information, strategic positioning, and mutual expectations can lock physician-patient dyads into suboptimal but stable interaction patterns. We propose intervention strategies including structured decision aids as neutral third parties, peer review mechanisms, and deliberate renegotiation protocols. By understanding physician-patient relationships as strategic games, healthcare systems can design interventions that facilitate cooperative equilibria rather than adversarial standoffs, ultimately transforming relational lock-in from a barrier to change into a foundation for collaborative care adaptation.