It may seem strange now, but there was a time when patients weren’t always included in their healthcare decisions. “Doctor knows best” was the vibe — and the practice. Would you believe that it used to be routine for patients to not be told what their diagnosis was? Healthcare providers (HCPs) or family members often made treatment decisions without telling or even asking the patient.
This still happens unfortunately but, thankfully, it’s no longer the norm.
Shared decision-making is a process where HCPs and patients work together to make healthcare decisions. HCPs might provide research and data about medications or procedures, and patients may provide their priorities and goals. The two parties work together to arrive at a decision about how to proceed.
Shared decision-making in healthcare shows respect for patients’ needs and values. And it has other benefits as well. Involving patients in their healthcare decisions can help people feel in control, make it easier and more likely that they’ll follow the plan for their treatment, and lessen the anxiety that often goes along with needing medical care.
Even though there are now laws in place to require involving patients more, it can still be hard for patients to make their preferences known. Many patients — especially women and people in traditionally marginalized communities — may worry about being labeled as difficult if they speak up or ask too many questions. Some people fear offending their HCP if they express their opinions. And many people feel unprepared or unqualified to have a say in their treatment options. HCPs are often rushed and may not always feel they can make time to share information and inlcude the patient. Not taking that time may be easier and faster for the HCP, but it can leave the person out of the loop and rob them of their power.
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Who is shared decision-making for?
The short answer is that shared decision-making is for everyone. There are emergency situations where HCPs have to act without consulting the patient. Your life may depend on their quick action and expertise, and you may literally be unable to weigh in. In those cases, you probably don’t mind giving up your share of the decision-making process.
But in many other cases, even some urgent situations, patients should have a voice in their care. For example, if you’re managing a chronic condition or you get a serious diagnosis, you probably have options for which treatment you get. If surgery could help you, but also introduces risks, you should be part of the decision to move forward or not.
Even when there is a clear standard treatment and there isn’t as much need for discussion, people have personal preferences and unique priorities. How much risk does a person want to take for a chance at getting better? Are they willing to tolerate side effects? Are there other considerations in their life that may change the equation for them? Some people may choose physical therapy for a knee injury, while others may choose surgery. A woman with multiple sclerosis (MS) may choose a therapy that is most effective for her but has a higher risk of side effects. Someone else may be more concerned about the side effects and might make a different treatment decision. Whenever possible, HCPs should talk to you to make sure your treatment reflects your wishes and preferences.
How to use shared decision-making to get better healthcare
If your HCP engages in shared decision-making with you, be ready to use your voice. And, if your HCP doesn’t approach you to share in decision-making, you can take the first step. You can even say, “I want to make sure I fully understand my options before we move forward.” That will signal to your HCP that you are an engaged patient, and they need to partner with you in your healthcare decision.
Here are some tips for engaging in shared decision-making to get the best care:
- Bring a list of questions with you so you can be sure you cover everything you’d like to go over during the visit.
- Ask about the risks, pros and cons of each treatment option.
- Ask what options other people tend to choose and why.
- Ask how treatment options might affect the things that are important to you. For example, if you want to keep up an active lifestyle or want to get pregnant, make sure your HCP knows and explains how any treatment would affect those aspects of your life.
- Find out what your HCP recommends. You can trust your HCP and still want to feel like you’re making a fully informed decision for yourself.
- Ask what is likely to happen if you don’t move forward with their recommendation.
- Research your condition and treatment options using credible sources so you are well-informed going into the conversation.
Resources
Multiple Sclerosis: Shared Decision Making Tools
This educational resource was created with support from Novartis, a HealthyWomen Corporate Advisory Council member.
