Informed Medical Decision Foundation -- US

[MBombardier]

http://www.drbriffa.com/2012/07/13/orga ... -delighted

I hope the Informed Medical Decision Foundation and the concept of shared decision making gets the attention it deserves. I also hope that more doctors ‘get with the programme’. In a way, I sense some doctors will be forced to embrace this way of doing medicine. Otherwise, they risk have dwindling positive impact on their patients, as well as dwindling numbers of patients.

One of the doctors attached to the Informed Medical Decision Foundation (Dr Michael Barry) recently co-authored a piece in the New England Journal of Medicine about shared decision making which you can read here.

This piece points to research in which improved outcomes and perhaps reduced burden on healthcare services. Here’s an excerpt:

Just as there are randomized trials of tests and treatments, there have been randomized trials of shared decision making supported by patient decision aids. According to the latest Cochrane review of 86 trials published through 2009, the use of patient decision aids for a range of preference-sensitive decisions led to increased knowledge, more accurate risk perceptions, a greater number of decisions consistent with patients’ values, a reduced level of internal decisional conflict for patients, and fewer patients remaining passive or undecided.The use of decision aids is also associated with patients’ choosing prostate-specific–antigen tests for prostate-cancer screening and major elective surgery less often, which suggests that shared decision making could be a tool to help address the problems of overdiagnosis and overtreatment.

The piece ends with this paragraph:

If we can view the health care experience through the patient’s eyes, we will become more responsive to patients’ needs and, thereby, better clinicians. Recognition of shared decision making as the pinnacle of patient-centered care is overdue. We will have succeeded in building a truly patient-centered health care system when an informed woman can decide whether to have a screening mammogram and an informed man can consider whether to have a screening prostate-specific–antigen test without their clinicians labeling the decision “wrong” on the basis of different values and preferences.