Shared Decision Making

Today we talked a lot about shared decision making.  We often want patients to agree with what we think is best, but what we think is not always correct or in line with what the patient values.  We are not here to act out our will.  We are here to help our patients enact theirs.  Certainly we should educate them.  If their initial preferences seem to be uninformed or rooted in fears we can alleviate we shouldn’t just wash our hands of the matter in the name of patient autonomy.  But we absolutely cannot inflict our values on them because “doctor knows best.”

Shared decision making takes time.  Time most healthcare workers feel they do not have.  After today’s discussions, however, I feel it is definitely time well spent.  Not only is it the ethical thing to do, I think it has great potential to strengthen patient-clinician relationships and increase compliance.  If we take the time to learn our patients’ values, goals, and concerns, we can make them feel more involved and invested in their own care.  It won’t be something we are doing to them but something we are helping them do for themselves.  That is the best way to obtain long-term success and a healthier population.  Plus, given how many errors can occur do to rushing or not double-checking, I am all for practices that force us to slow down and re-assess our goals and tactics.

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