Making decisions for vs. with the patient

As a 3rd year internal medicine resident, I have so many times made decision for my patients without asking them for their opinion about it. Most of the time, it has been as routine as starting a new blood pressure medication while not talking to the them about the possible side effects that I have found to be one of the important factors resulting in non-adherence by my patient to that medication and then having them labeled as “uncontrolled HTN in the setting of non-adherence to medication”.  What I have learned in only 3 years is that when it is a shared decision the results are much better, patients are less likely to be non-adherent and they  trust in me and team more.  Yesterday we had a session on the consent form and the value and importance of shared decision-making. We talked about catastrophic consequences of lack of shared decision-making, which made me realize that shared decision-making is a corner stone in more stressful situations such as a new diagnoses of cancer in a patient. We as health care providers are the main source of information for most of our patients and they trust us to take care of them, and having them involved in the process as the focus of all the decisions we make is what we should always remember.

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