Shared decision making: a model for the physician-patient relationship in the 21st century?

2003 ◽  
Vol 107 (6) ◽  
pp. 401-402 ◽  
Author(s):  
Wayne S. Fenton
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
21St Century ◽  
Shared Decision ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Physician Patient

Prudence in Shared Decision-Making: The Missing Link between the “Technically Correct” and the “Morally Good” in Medical Decision-Making

2020 ◽  
Author(s):  
Paul Muleli Kioko ◽  
Pablo Requena Meana
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Autonomy ◽  
Intellectual Ability ◽  
Medical Decision ◽  
Shared Decision ◽  
Physician Patient Relationship ◽  
Good Healing ◽  
The Right ◽  
Physician Patient

Abstract Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for and with a particular patient. We argue that by perfecting the intellectual ability to apprehend the complexity of clinical situations, and through a perfection of the application of the first principles of practical reason, prudence is able to point toward the right and good shared medical decision. A prudent shared medical decision is therefore always in keeping with the kind of person the physician and the patient have chosen to be.

scholarly journals Decision-Making of Older Patients in Context of the Doctor-Patient Relationship: A Typology Ranging from “Self-Determined” to “Doctor-Trusting” Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Jennifer Wrede-Sach ◽  
Isabel Voigt ◽  
Heike Diederichs-Egidi ◽  
Eva Hummers-Pradier ◽  
Marie-Luise Dierks ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Information Seeking ◽  
Older Patients ◽  
Self Determination ◽  
Shared Decision ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Good Doctor ◽  
Patient Decision Making

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.

Frequent Flyer

2020 ◽  
pp. 121-128
Author(s):  
Catherine A. Marco
Keyword(s):  
Therapeutic Interventions ◽  
Patient Comfort ◽  
Shared Decision ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Frequent Flyer ◽  
Course Of Action ◽  
Practice Of Medicine ◽  
The Individual ◽  
Physician Patient

Stewardship of health care resources is an important bioethical tenet of the practice of medicine. Physicians should act as stewards of resources and ensure that they are appropriately used to provide the best possible medical care for individual patients and for society as a whole. As in all cases of the physician-patient relationship, goals of therapy should be delineated, and appropriate diagnostic and therapeutic interventions to achieve that goal should be undertaken. Emergency physicians should advocate for the best treatment of the individual patient. In most cases, physician and patients agree, with the same goal of improving patient comfort and health. However, at times, there may be discordance between patient and physician. Shared decision-making should be undertaken to elicit the patient’s goals and values and then to educate and inform the patient about the physician’s recommendations. The goal is to reach a mutually agreeable course of action based on the patient’s goals and values. If unable to reach agreement, the physician should offer the tests and therapy that offer the best good to the patient.

scholarly journals The Roles of Health Literacy and Physician-Patient Relationship in Self-Reported Health Outcomes Within a Diverse Sample of Persons Living with HIV

2019 ◽  
Vol 34 (7) ◽  
pp. 1273-1273
Author(s):  
E Santana ◽  
J Gonzalez ◽  
D Byrd ◽  
M Rivera Mindt
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Health Literacy ◽  
Health Outcomes ◽  
Physical Functioning ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Physician Patient

Abstract Objective Barriers like poor health literacy and patient-provider communication add to health disparities in diverse populations. Perceived autonomy has been shown to improve patients’ health satisfaction and knowledge of their illness. However, no studies have examined these issues in HIV patients. This study examined the roles of health literacy and physician-patient relationship in health outcomes (e.g., mental health and emotional/physical functioning) in persons living with HIV (PLWH). Participants and Method This cross-sectional study included 91 PLWH (74% Latinx and 26% non-Latinx White; 68% Male) who completed the Test of Functional Health Literacy in Adults (TOFHLA), Physician–Patient Relationship Scale (PPRS), and Medical Outcomes Study-HIV Health Survey (MOS). The study variables included: TOFHLA total score, PPRS Part Decision- Making (PDM) and Trust subscales, and MOS Mental Health and Health Transition subscales. Results A linear regression showed that our model (ethnicity, TOFHLA, PPRS PDM and Trust) predicted MOS HT (R2 = .14, p < 0.05), such that Latinx ethnicity (β = .30) and better TOFHLA scores (β = -.22) predicted better MOS HT scores (ps < .05). Another regression showed that our model predicted MOS MH (R2 = 0.07, p = <.01), such that greater PPRS PDM scores predicted better MOS MH scores (β = .27, p = <.01). Conclusions Ethnicity and better health literacy were related to improved emotional/physical functioning over a 4-week period and greater shared decision-making was related to better overall mental health. These findings highlight the importance of identifying sociocultural factors and interpersonal processes of care to inform culturally-tailored interventions that can result in enhanced and effective treatment for PLWH patients and in improved physical and mental health outcomes.

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