Shared Decision Making an Essential Part of Doctor/Patient Relationship

Shared decision making is an essential part of the doctor/patient relationship, yet many patients are wary of voicing their opinions to doctors for fear of being labeled “difficult.”

But collaboration between patient and doctor is absolutely essential for successful treatment. Doctors need patients just as much as patients need doctors.

Dr. Silverman Comments

During each patient visit I sit down with the patient and their family to discuss treatment options. After we’ve discussed their case, I provide a diagnosis and treatment in a clear and understandable manner, tailored to each patient’s needs.

I explain the risks and benefits of the following three options:

• Option 1: Live with it and do nothing. This is a very important option to leave on the table when the condition will not cause eminent bodily harm. Understanding this option lets patients come to other treatment decisions without pressure and on their own time schedule.
• Option 2: Non-surgical treatment. This option lets patients try to accommodate while the body attempts to heal or become accustomed to the disorder. Sometimes this means longer recovery times with lower risks; sometimes this means temporizing a condition until a later date; sometimes it is futile but it gives the patient a better sense of control of their destiny. I encourage non-surgical treatment in many cases.
• Option 3: Surgical treatment. This is often the most conservative option for those patients who want rapid recovery and best overall function after treatment. A strong understanding of the previous two choices is necessary to consider this option.

I have my bias since my education, experience, and on-going study has taught me what works and what doesn’t. I do not assume an authoritarian role unless I hear the line of fear—”Whatever you think is best, Doctor.” Only then do I make explicit demands of my patient. They must help me to make the decisions as they need to be as invested in their care as I am. Regardless of their choice, I stand with the patient on their decision and help guide them to the best of my abilities.