Why Shared Decision Making
FOR IMMEDIATE RELEASE
Physicians favor patient involvement in decision making, but cite barriers such as time and money
Reform movement could break down barriers and reduce over-treatment and waste in system
BOSTON, Massachusetts, March 19, 2009
—Most primary care physicians would like their patients to be better informed about their medications, the tests they undergo, the lifestyle changes that would improve their health, and the surgery options they are offered. The majority also favor shared medical decision-making, whereby doctors and patients work together to make decisions. However, they cite too little time and an unsympathetic reimbursement structure as major barriers to routinely involving and informing their patients in medical decisions, according to the largest national survey to date on physicians’ attitudes about shared decision-making. Survey results of over 400 physicians, conducted by Lake Research Partners for the Foundation for Informed Medical Decision Making, were published in a white paper released March 19, 2009 to government, health policy, and consumer advocacy leaders.
“Our hope is that this timely report will encourage health reform advocates and leaders to keep the needs of patients and the concerns of physicians on this issue at the forefront as they design improvements to the infrastructure of our health care system,” says Floyd J. Fowler, president of the Foundation for Informed Medical Decision Making.
The Foundation for Informed Medical Decision Making believes that informed decision-making is a patient’s right and if patients are fully supported in exercising that right, health care costs and over-treatment will decline, while care will be more in line with what patients value.
“To truly transform our health care delivery system into one centered on the patient, we need to develop better tools and approaches to help patients make decisions about their care,” says Debra L. Ness, President of the National Partnership for Women & Families. “When patients are given accurate and unbiased information about their treatment options, they tend to make more conservative and less invasive decisions that often result in better outcomes. The Foundation’s research underscores the priority we must place on engaging patients in their care decisions and encouraging a model of active patient participation.”
The Congressional Budget Office estimates that the US spends as much as $700 billion – 5 percent of the nation’s entire GDP – on health care services that do not improve patients’ outcomes. Health policy leaders are advocating for reimbursement reform to include patient’s involvement in treatment choices and decisions as they identify key strategies to rein in the over consumption of ineffective medical care.
“Increasingly, patients are faced with medical decisions that have many options, uncertain outcomes, and benefits and harms that are valued differently by each individual,” and “patients and providers bring different expertise to the decision,” the paper’s authors write. “Providers are mainly responsible for assimilating and appropriately applying evidence-based information, and patients are responsible for sharing their preferences.” By using shared decision-making, they add, “physicians can determine which choice best matches what is most important to the patient and deliver high quality care that is “both evidence-based and patient-centered.”
The survey questioned physicians on experiences with, benefits of, and barriers to shared decision-making. It also explored factors that influence if and when physicians engage patients in shared decision-making, their willingness to use patient decision aids that provide unbiased information in user-friendly ways, and their reactions to specific ideas for increasing patient involvement in shared decision-making.
The team found that overall physicians support the principle of shared decision-making. However, physicians identify the lack of adequate time with patients as a major challenge, and they raise some concern about the ability of patients to understand all they need to know
Overwhelmingly, physicians responded that reimbursement for the use of patient decision aids and time spent counseling patients around decision choices would allow physicians to fully embrace the shared decision-making process.
About the Foundation for Informed Medical Decision Making
The Foundation for Informed Medical Decision Making’s mission is to assure that people understand their choices and have the information they need to make sound decisions affecting their health and well being. The Foundation organizes and frames medical evidence in an unbiased manner to help people evaluate their options, particularly in instances where differences in individual preferences and perspectives are likely to affect personal choice.
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