Getting Started with Shared Decision Making

You should think about opportunities to involve your patients more (and their caregivers, when appropriate) in their care. Some opportunities include:

• Deciding whether to start an insulin pen with Type 2 Diabetes
• Deciding about low dose lung cancer screening
• Deciding whether to receive a vaccine
• Discussing advance care planning

Four steps to better shared decision making include:

• Invite your patient to take part in the decision-making process – ask if they are willing to discuss reasonable options.
• Present all reasonable options in simple, easy to understand language
• Assist patients in evaluating each option based on their preferences, goals, and values
• Reach a decision with the patient as your partner and help with the next steps

Additional tips:

• To help start a meaningful discussion, consider the complexity of the patient's condition and options.
• Speak slowly and avoid complex medical terminology.
• Use active listening and provide information in small segments, giving the patient time to think and respond.
• Use teach-back to assess the patient's understanding of their options.
• You may also want to consider having access to interpreter services or visual aids available.

If you are interested in more practice to develop your skills, visit our Skills Course and Coaching information.

Your patients may need to make important decisions about their health and treatment options and could be feeling overwhelmed. You are seeing the patient not only because of your specialized skill set but also because of the complexity of the situation and how there may be more than one reasonable approach/treatment plan.

Patients and caregivers may be open to shared decision-making and are also looking for your guidance and knowledge.

Some opportunities include:

• Deciding about treatment(s) for breast cancer
• Deciding about taking medication during pregnancy
• Deciding between surgical or medical treatments for a condition
• Discussing advance care planning

The four basic steps in shared decision making include:

• Invite your patient to take part in the decision-making process. Ask if they are willing to discuss what options would be reasonable to consider
• Present all reasonable options in simple, easy to understand language
• Assist patients in evaluating each option based on their preferences, goals, and values.
• Reach a decision with the patient as your partner and help with the next steps.

Additional tips:

• When partnering with a patient who is facing a difficult decision, invite family or caregivers to be part of the discussion.
• Provide the most up-to-date evidence on the risks and benefits of each option, as well as the best, worst, and most likely potential outcomes.
• Consider the patient's goals and values before assuming there is one “correct" treatment. It can be helpful to include no disease-focused treatment/best supportive care as an option.

If you are interested in more practice to develop your skills, visit our Skills Course and Coaching information.