Shared Decision Making

Summary

We often rely on our doctors to tell us what care we need. But to get the best care, you and your doctor should make decisions together. This process is called “shared decision making.” Your doctor shares medical expertise, and you share what you want out of your care. Then, you make a decision together.

Shared decision making is helpful if there is more than one way to treat your health problem, and there’s no clear “right” choice. Your doctor can give you a “decision aid,” which is often a flyer or video that explains the different choices and their risks and benefits. Decision aids also help you think through your own priorities and values. Then, you and your doctor can talk through the options and your questions.

Ask your doctor about her or his shared decision making approach. If she or he does not have a formal approach, you can still take more control of your care by:

Asking your doctor about the pros and cons of each treatment.

Talking to your doctor about how much each option will cost, and whether there are lower cost treatments that work just as well.

Using educational decision aids or other tools to help you make the best decision.

Visiting websites and organizations for people with your health condition to connect with others who are going through the same experience.

Getting a better idea of what decision aids look like from the Mayo Clinic and the Informed Medical Decisions Foundation.

With a “shared decision making” process, your doctor shares medical expertise, and you share what you want out of your care. Then, you make a decision together.

How Does Shared Decision Making Work?


Usually, when a doctor recommends a treatment, she or he gets your “informed consent.” This means the doctor tells you what the treatment is, what benefit you will get out of it, and what the risks might be. Then, you agree (or don’t agree) to the treatment.


Shared decision making is a different approach. It’s helpful when there is more than one way to treat your health problem, and there’s no clear “right” choice. Your doctor talks to you about your options. He or she may also give you a “decision aid”, which is often a flyer or video that explains the different choices and their risks and benefits. Decision aids also help you think through your own priorities and values. Then, you and your doctor can talk through the options and your questions.


Doctors are now using a shared decision-making approach for many different health issues. Some of these are:


Pregnancy: If you had your first baby by Cesarean section, you and your doctor can talk about options for delivering your next baby. If you don’t want another C-section, your doctor can help you decide if you can safely try a vaginal birth.

Heart disease: Heart disease can be treated with prescription drugs, or with drugs plus a stent. A stent is a tube that your doctor puts in a blood vessel to help it stay open and keep the blood flowing. If you’re uncomfortable with surgery, you and your doctor might decide to try medication on its own for a while, and see if that works.

Prostate cancer: Prostate cancer can be treated with surgery. But, that surgery can have side effects like impotence. Another option is “watchful waiting”, where you have regular tests to make sure the cancer doesn’t get worse. If you want to take action right away, you and your doctor might decide surgery is the way to go. If you don’t want to risk the side effects, you might choose to wait.

How Can I Have More Say in My Care?


More and more doctors are using shared decision making. Washington State, for example, even has a law supporting it. Ask your doctor if they use a shared decision making approach. If they don’t, you can still take more control of your care by:


  • Asking your provider about the pros and cons of each treatment. Ask your provider to explain anything that you do not understand. Bring a list of questions to your appointment, so you don’t forget anything.
  • Asking how much each option will cost. Staying healthy should be the most important part of your decision. But, if you’re worried about money and a lower-cost treatment would work just as well, it may be a better choice for you.
  • Asking if there are educational decision aids or other tools to help you make the best decision.
  • Visiting websites and organizations for people with your health condition. You can learn a lot by connecting with others who are going through the same experience.
  • Getting a better idea of what decisions aids look like from the Mayo Clinic and the Informed Medical Decisions Foundation
 

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