Helping Patients to Make Better Decisions

It would be easy for clinicians to conclude that, if patients are going to make bad decisions because of emotions, mispredictions, or an inability to make difficult choices, then they should give up on involving patients in their healthcare decisions. But this would be a mistake. It would violate legal and ethical norms, it would reduce patient satisfaction and treatment adherence, and it would leave patients vulnerable to physicians' own biases. Physicians make many of the same mistakes patients make, for example, avoiding difficult decisions and mispredicting the emotional consequences of health problems. In addition, physicians are prone to specialty biases; urologists, for example, have very different attitudes toward radical prostectectomy from radiation oncologists55 and different attitudes toward PSA testing from primary care physicians.56

For these reasons, we think clinicians should not abandon the idea of involving patients in their healthcare decisions. Instead, we recommend the use of several strategies to facilitate this task.

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