Shared Decision-Making

John Fisher
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Stopping Medical Injustice


More often than not patients find themselves unable to speak up when they are at the doctor’s office.  Patients reasons for not asking questions or inquiring too much are often excuses such as not wanting to question the doctor’s judgment or finding that the doctor seems too busy and uninterested in them. 


For several years a number of different groups have tried to close the communication gap between doctors and patients in order to practice medicine more effectively and treat to patients’ needs.  Research groups, advocacy groups, even entire conferences have been dedicated on working towards this goal—when patients and doctors work together in making decisions about care and treatment, both parties are more satisfied with the outcomes. 


However a recent study found that the piece of the puzzle that is missing is actually patient’s perspectives on how to communicate better with physicians.  Most of the focus has been entirely on the physician end. 


The study focused on 48 patients from five different primary care physicians’ offices.  First the patients were educated on various different, but equally effective, treatments for heart issues.  They were then asked about how they would discuss these treatments with their doctors if they were given several different treatment options for their own care.  Lastly they were asked if they would feel comfortable asking their doctor about alternative treatments, other than those that may be presented to them by their doctor or even disagreeing with their doctors.


The study revealed that most patients felt as if they wanted to be a part of the decision-making for their own treatment but felt as if they were limited in the discussions they could have with their doctor, for several reasons.  First, many patients reported their doctors were more authoritarian versus authoritative.  Second, most believed they would upset their doctor if they questioned their judgment or suggestions because patients felt their doctor knew best.  Lastly, and not surprisingly given the high volume of information available on the Internet, many patients felt they could get more information, and better information on their own.


While the focus on working towards a more collaborative relationship between physicians and patients isn’t going away any time soon, the patient perspective is finally being studied and this may kick the movement into gear and effectuate some positive results; fostering better relationships between physicians and patients. 


But what do you think?  I would love to hear from you!  I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at [email protected] .  You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at

I am from Russia and I have been shocked with the doctors' appointments in USA. In most cases it's constant feeling *rushed to leave". Doctors are usually too busy to talk with the patients and explain anything.I understood that it's patients' responsibility in the fully study the medical subject regarding their health problem,if they want to understand at least something. My American friend advised me get used to the "appointments" like this:"Hello,how are you? Here is the prescription. Here is the procedure cost list.Have a nice day".She said that the most of American doctors' appointments are this way.The patients kind of have a right to be informed and be given a treatment-choice. My "doctor" didn't give me even a word of information,important notifications and any choice ever.He has made so many bad mistakes and caused me lots of harm and expenses, but was found highly professional as a result of Medical Board "investigation" despite lot's of proof of his extremely negligence I submitted.I am surprised that American patients don't protest such obvious *pro-doctors/anti-patinets* situation in the U.S. I made a conclusion that instead the main doctors' maxim "Do no harm" American doctors should just follow *Don't do TOO MUCH harm* to avoid any liability and stay out of trouble.
by Lana Williams June 11, 2012 at 09:37 AM
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