Why isn’t shared decision making standard practice?

Good piece on shared decision-making, and why it is still hard for some people to have an open dialogue with their doctor on options and choices. Quote:

So, although shared decision making is something that both doctors and patients say they want, we still have a long way to go to get to a fully functional shared decision making model. This is not to point fingers at doctors or patients, but rather to acknowledge that many of came of age at a time when doctors possessed the knowledge and, therefore were given the authority, to make decisions for patients. Now that the Internet has democratized medical knowledge (as it has so many other aspects of modern life), the role of the physician will need to evolve, as one patient put it:

“…What I want them to be is my friendly native guide through this jungle of decisions and a full partner in executing that decision.”

Hard to argue with that, and I am fortunate to have this kind of relationship with my lymphoma medical team as well as our family doctor.

Why isn’t shared decision making standard practice?.

What do you think?