Takeaway
We need a new shared decision-making paradigm where all possibilities for care are out on the table, including unconventional ones. A clinician’s humility and openness are especially important now that patients are more emboldened to question the opinions of experts.
Connecting with Patients | April 16, 2025 | 1 min read
By Jeffrey Millstein, MD, Penn Medicine
Shared decision making was born out of the modern ethics of patient self-determination, but most often revolves around clinician-driven information. Medical facts are presented, options outlined, risks and benefits based on available scientific studies discussed, and doctors help patients make informed decisions aligned to their personal values and priorities.
Today, patients are more likely to bring self-generated information to the discussion, including some that may come from dubious sources. Like it or not, this is the world we live in, and fact-checking, head-on debate, or claiming moral high ground are often ineffective at swaying opinions and influencing decisions.
So what can clinicians do?
1. Start from a more curious, open-ended place and invite patients’ thoughts and ideas from the outset.
Assessing what patients already know and how they came to know this information can be very affirming for them. This approach also conveys a clinician’s humility, openness to receiving unconventional information, and acceptance of a more collaborative power dynamic.
2. Encourage patients to explore self-reflection and their intrinsic motivation, and allow them to take greater ownership of their decisions.
Focusing too quickly on medical expert-centered options can drive away growing numbers of people entrenched in their own media odyssey.
3. Today, shared decision making needs to start with shared information.
Clinicians need to at least welcome and acknowledge all ideas brought to them and apply a curiosity lens to understand why those ideas resonate with the patient.
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This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.