The Cost of Assuming Doctors Know Best – Shannon Brownlee & Joe Colucci – The Atlantic

A good piece, noting that shared decision-making between doctors and patients ensures patient priorities and wishes are respected, and results in less invasive treatment and reduced costs.

Given that most healthcare financial incentives are based on providing treatment (doing more), shared decision-making may be one means to counter this tendency, pending development of more balanced incentive and compensation regimes. Quote:

Shared decision making is a process designed to ensure that patients are fully informed, and then use that information to get the treatment they want. A common though non-essential part of informing patients is a “patient decision aid.” Decision aids can be videos, websites, or pamphlets, and they present the available medical evidence on all reasonable treatment options — including the option to do nothing — in a way that patients can understand. Decision aids also help patients understand what they value and how much risk they’re willing to accept. Doctors can participate in the process, too, by clarifying things for the patient and helping make sure there’s a good match between the treatment and what the patient wants.

There have been more than 80 randomized controlled trials on the effects of patient decision aids, and the results are pretty clear. According to the Cochrane Collaboration, which reviews groups of studies, using patient decision aids improves the match between patients’ preferences, improves patients’ knowledge of the possible results of treatment, and reduces the number of patients who still don’t know what they want.

The Cost of Assuming Doctors Know Best – Shannon Brownlee & Joe Colucci – The Atlantic.


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