Toward a Communication-Based Perspective on Shared Medical Decision Making.

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    • Abstract:
      Shared decision making has been advanced as a means of improving quality of care and fulfilling the mandate to change the delivery of healthcare from a paternalistic to more a collaborative practice. However, there are significant impediments to implementing shared decision making initiatives, including equivocal data about its benefits and resistance on the part of patients and providers alike. It is suggested that a communication-based perspective can lead to a richer of understanding of shared decision making, assist practitioners and researchers in overcoming the limits of the one-way, message-based, approach that predominates much of the current literature, and pose a viable alternative to the practice of making treatment decisions without incorporating the experience of patients. The paper presents and discusses three characteristics of an interpersonal perspective: 1) It brings the knowledge and expertise of the provider together with the goals and experience of the patient. 2) It appreciates the crucial role that uncertainty plays medical decision making. 3) It focuses attention on the evolving relationship between patient and provider. The paper concludes by discussing current efforts to utilize this perspective to examine how shared decision making can impact quality of care. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]
    • Abstract:
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