There are at least 300 million major medical decisions made in the US each year. Most decisions are made with the patient in a state of avoidable ignorance about the risks and benefits of the proposed treatment and of its alternatives.
Our legal concept of “informed consent” was created to put us on a better path—but the way we implement it is a far cry from its original intent. While many hundreds of high quality patient decision aids now exist, most patients and most doctors have never even heard of them. This post is about moving shared decision making into the mainstream of clinical care.
The goal of mainstreaming on a river is to find the sweet spot in the current that takes you where you want to go fastest and with the least effort and with the least risk. It takes a keen eye, experience and the right tools to find that sweet spot. In medicine getting to the mainstream means getting into the routine workflow of clinical practice. In fact, some say the three most critical factors for getting shared decision making into clinical practice are: workflow, workflow, workflow. The goal is to get the patient to the right decision, the fastest, with the least amount of effort and with the least amount of risk.
When we get sick the same questions come up again and again: