LYMEPOLICYWONK: Is shared decision making the wave of the future?
Medicare now requires “shared decision making” before it will pay for certain medical procedures.
Shared decision making involves a balanced discussion between patient and physician of the risks and benefits of treatment alternatives. Together, they choose a course of action. Think prostate cancer, where patients and their physicians choose between watchful waiting, radiation therapy, hormone therapy and surgery.
This viewpoint article in the Journal of the American Medical Association does a fine job of discussing the issues. I am liberally pulling my favorite quotes here but encourage you to read the full piece. In Lyme disease, the evidence base is quite poor and shared decision making has enormous potential to increase access to care and reduce long term costs of illness.
“Patient preferences should be incorporated into all clinical decisions, but mandatory shared decision making will probably have a larger influence on decisions in [cases] for which an evidence-based decision does not exist.”
“At its core, shared decision making involves a discussion between the patient and the physician that presents risks and benefits of alternative treatments in a balanced manner, elucidates each patient’s preferences and goals, and engages patients in decision making.”
“Shared decision making has the potential to reduce costs and align treatment with the preferences of patients. Patients exposed to decision aids are more knowledgeable about their condition, perceive risks more accurately, seem more likely to reach decisions consistent with their preferences, and also appear less likely to choose elective invasive procedures vs more conservative and less expensive options.3”
“All treatment decisions are sensitive to preference to some degree, and patient engagement should be encouraged as part of good practice.”
Lorraine Johnson, JD, MBA, is the Chief Executive Officer of LymeDisease.org. You can contact her at firstname.lastname@example.org. On Twitter, follow her @lymepolicywonk. If you have not signed up for our patient-centered big data project, MyLymeData, please register now.