Medical Economics recently spoke with Peter Goldbach, MD, chief medical officer with Health Dialog, a provider of population health management services, on the importance of shared decision-making in medical care and improving patient outcomes.
Goldbach will be among the featured speakers at a March 2018 National Quality Forum workshop on shared decision-making, sponsored by Thomas Jefferson University in Philadelphia.
ME: Let me start by asking you to define the concept of shared decision-making.
PG: Shared decision-making is a collaborative process that enables patients and providers to make healthcare decisions together that take into account the best medical information as well as a patient’s preferences.
ME: Why is it important to healthcare and particularly to improving patient outcomes?
PG: Well, you know research has shown that patients often make decisions in the face of what some have termed to be avoidable ignorance. For example, out of the University of Michigan some time ago there was a telephone survey called the Decisions Trial. And it found that for eight out of 10 decisions, less than half of the respondents could answer more than one knowledge question related to the treatment that they received.
So it’s very common that patients have very incomplete information when they’re asked to make a decision. And these kinds of medical decisions for which there are choices are very common. There’s also research that shows that physicians often make or help make patients make decisions without having knowledge about patient preferences. So shared decision-making is there to try to help the physician/patient dyad work better.
ME: How can doctors help patients fill that knowledge gap?
PG: Yeah, that’s a great questions and it’s not easy as you can imagine a clinical practice is a very busy place and there’s a lot of knowledge that needs to be transferred. And so part of shared decision-making usually involves the use of an instrument called the decision aid, which is a way of helping patients get educated about using unbiased information about their medical condition, about the various evidence-based treatments that might apply to their situation and it gives them unbiased information about the expected outcomes, both positive and negative, and then also invites them to think about their lifestyle and their preferences to try to consider which treatment choices might work best for them and help them prepare to work with their physician.
ME: What is the role of family members in shared decision-making?