Shared Decision Making In Health Care

Over the past decade health care systems around the world have placed increasing importance on the relationship between patient choice and clinical decision-making. In the years since the publication of the second edition of Shared Decision Making in Health Care, there have been significant new developments in the field, most notably in the US where 'Obamacare' puts shared decision making (SDM) at the centre of the 2009 Affordable Care Act. This new edition explores shared decision making by examining, from practical and theoretical perspectives, what should comprise an effective decision-making process. It also looks at the benefits and potential difficulties that arise when patients and clinicians share health care decisions. Written by leading experts from around the world and utilizing high quality evidence, the book provides an up-to-date reference with real-word context to the topics discussed, and in-depth coverage of the practicalities of implementing and teaching SDM. The breadth of information in Shared Decision Making in Health Care makes it an essential resource for policy-makers and health care workers. As health care systems adapt to increasingly collaborative patient-clinician care frameworks, this will also prove a useful guide to SDM for clinicians of all disciplines.

First edition published as: Evidence-based patient choice.. Oxford: Oxford University Press, 2001.

An evidence-based analysis of the opportunities and challenges of moving towards more person-centred health systems.

Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty

The Mayo Clinic physician and founder of The Patient Revolution offers a “thoroughly convincing. . . call to action for medical industry reform” (Kirkus). Winner of the 2018 PenCraft Award for Literary Excellence, Why We Revolt exposes the corruption and negligence that are endemic in America’s healthcare system—and offers a blueprint for revolutionizing patient care across the country. Through a series of essays and first-hand accounts, Dr. Victor M. Montori demonstrates how the system has been increasingly exploited and industrialized, putting profit before patients. As costs soar, the United States continues to fall behind other countries on patient outcomes. Offering concrete, direct actions we can take to bring positive change to the healthcare system, Why We Revolt is an inspiring call-to-action for physicians, policymakers, and patients alike. Dr. Montori shows how we can work together to create a system that offers tailored healthcare in a kind and careful way. All proceeds from Why We Revolt go directly to Patient Revolution, a non-profit organization founded by Dr. Montori that empowers patients, caregivers, community advocates, and clinicians to rebuild our healthcare system.

Patients today are more empowered and knowledgeable than they have ever been. By law, they must be told about the risks and benefits of proposed treatments and give informed consent before treatment is initiated. Through the democratization of medical information, they have access to peer-reviewed medical journals. Social media allows patients to share stories with others and to learn about other people's experiences with various treatments. There are websites written by experts at leading medical schools to help patients understand diseases and treatments. They have the right to see their medical records. The net result of all changes is a shift in the power balance between doctors and patients. Ideally, as a result of these shifts, the patients' values and preferences should guide treatment decisions. However, this proliferation of information often leads to confusion rather than clarity. Publicly available information often includes seemingly contradictory conclusions and recommendations. Patients don't know which opinions to trust. So, although patients have more information than ever, and many want to make decisions for themselves, they need more guidance than ever to help them process an avalanche of information. This volume aims to help both medical professionals and their patients navigate the evolving healthcare landscape by analyzing the process of shared decision-making (SDM) in clinical medicine. The concept of SDM has emerged in the last two decades as a middle ground between, on the one hand, old-fashinioned physician paternalism of the "doctor-knows-best" variety and, on the other hand, unfettered patient autonomy by which patients are thought capable of individually and independently choosing their own medical interventions. Advocates of SDM imagine that decisions will be made best if they follow a complex discussion and negotiation between doctor and patient; such discussions should incorporate the doctor's medical and technical expertise as well as the patient's goals, values, and preferences. SDM takes different forms for different patients in different clinical circumstances. This volume gathers experts in SDM to share their insights about how it ought to be done. The authors include clinicians, social scientist, and philosophers, all of whom have thought about or cared for patients from a variety of backgrounds and in a variety of clinical circumstances. The papers explore the complexity of SDM and offer practical guidance, gained from years of experience, about how to employ SDM as effectively as possible.