Shared Decision Making

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’s 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.

Shared decision making can be especially helpful in certain cases, such as palliative care. That’s a type of care meant to provide comfort to a patient with a serious, chronic illness whose quality of life has decreased as a result of the illness.

Shared Decision Making Initiative: Palliative Care

 

Palliative care is used to ease pain and discomfort in patients who are seriously ill and help them enjoy everyday life. It treats the symptoms of an illness (like nausea or trouble sleeping), not the illness itself. Patients getting palliative care can still have medical treatments that might cure the illness. Palliative care is not the same as hospice care. Patients receiving hospice care are no longer receiving treatment for their illnesses

Helping patients and their caregivers to know the choices they have for medical treatment can help patients get the care that they prefer. Shared decision making can play an important part in making those choices. In shared decision making, the patient and his or her healthcare provider discuss the advantages and disadvantages of different medical choices. This helps patients to decide on tests, treatment and care. Decision aids are tools used in shared decision making to show patients different medical treatment choices for their health problem. The decision aids also show the possible results of those treatment choices. Together, the patient (or caregiver) and the healthcare provider choose a treatment that accounts for the patient’s values and preferences.

Some patients and their caregivers also may want to know the costs of different treatment choices. In the past, decision aids haven’t shown information about medical treatment costs. Now, FAIR Health, with support from The New York Community Trust, has launched a new feature on this website to give patients free access to decision aids that have both treatment and cost information.

Together with Dr. Glyn Elwyn of the Dartmouth Institute, FAIR Health is providing online shared decision making decision aids for three palliative care situations. The decision aids are for patients, and caregivers of patients, who may need:

  • Kidney dialysis (for patients in kidney failure);
  • Nutrition options when swallowing is difficult; or
  • A breathing machine (ventilator).

These decision aids are for patients who are seriously ill .

Patients and their caregivers in these situations can use the decision aids to get some of the information they need to help them make informed choices. Decisions about palliative care are very sensitive. Patients and caregivers may also choose to talk about their decisions with a social worker, religious advisor or community member, in addition to their medical team.

The decision aids are not intended to be medical advice, diagnosis or treatment. They are intended to provide information to help you engage in shared decision making with health professionals.

Read our FH® Insurance Basics article on shared decision making and palliative care.