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Decision making by patients and physicians together.

Decision Making By Patients And Physicians Together Dominick Frosch and coauthors describe patients who feel rushed and physicians who don’t explain options or discuss patient preferences (May 2012). The authors propose shared decision making as an antidote but claim it has had “variable and weak” results in its application. Across eighty-six studies, a 2011 Cochrane Collaborative review found that decision aids help patients improve their knowledge of treatment options; have more accurate expectations of possible outcomes; arrive at decisions that are more consistent with their values; and participate more in medical decision making. The review shows that decision aids reduce elective surgeries and improve patient-provider communication. Shared decision making can be successfully deployed in the real world. In a recent Health Dialog study, decision aids with health coaching were offered by health plans to members and demonstrated appropriately reduced surgeries and decreased hospitalizations. Shared decision making can be deployed by physicians as well. The authors cite Group Health as a success story of patient communication but fail to mention that, since 2009, Group Health has widely adopted shared decision making, with 90 percent of its patients who used decision aids rating them very or extremely important. The Informed Medical Decisions Foundation has extensively researched shared decision making in practice and shares its experience on its website. Decision aids benefit patients and have been effectively incorporated into clinical practice. Peter D. Goldbach Health Dialog BOSTON, MASSACHUSETTS