There are five requirements for successful shared decision making (SDM) between patients and their clinicians.
- Knowing the pertinent science. This used to be the clinician’s job, but as the volume of information explodes and is democratized by the internet, it will increasingly be a shared task and dependent on technology. (Expecting a clinician to know all the pertinent facts is like expecting a travel agent to memorize all the plane schedules.)
- Knowing the available options, along with their potential benefits and harms. This, too, will gradually become a shared task, though interpretation and explanation (providing context and clinical perspective) will remain largely the clinician’s responsibility.
- Identifying the patient’s values and preferences. The clinician needs to be interested and the patient needs to be willing to disclose.
- Willingness to share power. Parallel to the clinician’s willingness to relinquish control is the patient’s willingness to accept responsibility.
- Time. The process of sharing information, and then asking and answering questions about the science, the options, and the patient preferences takes time and cannot be rushed.
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