As a patient, it is easy to become frustrated with the medical process, to feel as though you have no say in what’s happening to your body. Perhaps you leave your doctor’s office unsure of what decisions have been made or confused about the treatment you’ve been prescribed. Do these problems sound familiar to you? If so, you might want to talk to your doctor about shared decision making.
In a recent session of NATF’s online support group, Dr. Geoffrey D. Barnes, a cardiologist and vascular medicine specialist at the University of Michigan Frankel Cardiovascular Center and Institute for Healthcare Policy and Innovation, spoke to participants about shared decision making; what it is and how it works.
In his talk, Dr. Barnes spoke about three different forms of care that patients can receive from their doctor.
The first places all responsibility on the doctor. In this model, a patient provides the doctor with the information about their health, and the doctor then decides how the patient should be treated. This relationship happens often and is the best model for patients who either don’t want to be or are unable to be involved in their healthcare decisions.
A second form of care occurs when the patient becomes an “informed decider.” In this case, the doctor gives the patient information about their healthcare options, and then the patient takes on the role of decision maker.
The third form of care is shared decision making. It falls between the two other models. In shared decision making, a doctor and a patient work together to decide what treatment is best. According to Dr. Barnes, this involves discussing the patient’s diagnosis and treatment risks, while also considering what the patient prefers. From there, they reach a mutual decision.
Shared decision making works best when a patient wants to be part of their own treatment team. They want to make their treatment work with their lifestyle. On the opposite end, a doctor needs to be open to really listening to their patient, giving them the time they need to discuss their concerns.
“Doctors tend to over estimate how much time they are offering for shared decision making,” explained Dr. Barnes. He suggested that the best time for shared decision making is when there are multiple “clinically appropriate” choices for treatment.
One example discussed was the treatment of VTE. There are multiple drugs on the market for VTE and doctors must decide which one is best for their patients. Shared decision making would involve the doctor discussing the different drugs with the patient and working with them to decide on which is best. For example, if a patient often travels and would have trouble regularly testing their INR levels, a NOAC medication might be more appropriate than warfarin. The patient and the doctor would work together to decide what treatment is best.
Dr. Barnes discussed several benefits of shared decision making, saying that it leads to the best care for patients. It allows patients to be more informed about the reasons behind their healthcare. When patients are more involved in their care, there is an increase in patient satisfaction. They have less uncertainty about their treatment.
Doctors are still exploring the impact that this form of care has on treatment adherence and changing treatment choices.
The first step you need to take is to have a discussion with your doctor.
“Never be afraid to ask questions,” said Dr. Barnes, encouraging patients to ask questions about the treatments that their doctors put them on.
Some questions he suggested asking include:
It is never too late to start working with your doctor in order to take charge of your healthcare.
If you’re interested in learning more first-hand information from medical professionals like Dr. Barnes, make sure to sign up for our online support group.
For more on shared decision making, Dr. Barnes' full talk can be found here.