What are your preferences, needs, and values when it comes to your health? When confronted with an important medical decision do you and your doctor discuss how the various diagnostic and treatment options—including doing nothing—may effect the physical, emotional and social aspects of your life?
If Dr. Michael J. Barry and Physician Assistant Susan Edgman-Levitan had their way doctors would be asking their patients "What Matters to you?" as often as they do "What's the matter?"
Their article—Shared Decision Making—The Pinnacle of Patient-Centered Care which appears in the March 1st issue of the New England Journal of Medicine—points to the need for clinicians to "relinquish their role as the single paternalistic authority and train to become more effective coaches or partners...."
Patients, too, need to be educated about their role and given the tools and emotional support they need to fully participate in the process—without fear of criticism or judgment. Dr. Barry and Ms. Edgman-Levitan believe that by adopting the principles of shared decision making, "clinicians can help patients understand the importance of their values and preferences in making the decisions that are best for them."
This is especially relevant when a "patient arrives at a crossroads of [acceptable] medical options" each of which is associated with benefits and risks that may have profound and lasting effects. The authors cite as good examples: "... therapy for early stage breast cancer or prostate cancer, lipid-lowering medication for the primary prevention of coronary heart disease, and genetic and cancer screening tests...."
This is especially relevant when a "patient arrives at a crossroads of [acceptable] medical options" each of which is associated with benefits and risks that may have profound and lasting effects. The authors cite as good examples: "... therapy for early stage breast cancer or prostate cancer, lipid-lowering medication for the primary prevention of coronary heart disease, and genetic and cancer screening tests...."
Dr. Barry is President of the Informed Medical Decisions Foundation and Ms. Edgman-Levitan is a Board member. The organization, which was founded in 1988, works to advance shared decision making through research, policy, clinical models and patient decision aids. The Foundation's website offers a wealth of information, tools, and resources, including videos of patients and providers discussing their experiences with shared decision making.
Here's a brief introduction:
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