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The President’s Corner: May 2013
Shared decision making to inform and involve patients in their health care decisions is gaining great momentum as a strategy to improve the quality and value of health care. However, making patient participation in decisions the rule, and not the exception, is challenging. Now is the time to convene patient advocates, providers, health care systems, policy makers and insurers to engage in a critical discussion about how to address this challenge and make it easier to do the right thing by informing and involving patients when it matters most — when a decision is looming. Continue reading
Upcoming Stakeholder Meeting Aims to Raise Awareness of Misaligned Incentives in Health Care Reimbursement
In recent years, efforts to implement shared decision making (SDM) in routine clinical practice have advanced; however, implementation has proved challenging and numerous reports have identified misaligned incentives in health care reimbursement as a root cause. On May 23 and 24, leading researchers, providers, policy makers and payers focused on facilitating widespread implementation of shared decision making will convene in Washington, D.C. to participate in a critical discussion about how to better align incentives to foster this spread. Continue reading
An Interview with Ishani Ganguli, MD
As part of the first-ever Shared Decision Making Month this past March, the Informed Medical Decisions Foundation interviewed Dr. Ishani Ganguli, a second-year resident at Massachusetts General Hospital’s own primary care innovation, the Ambulatory Practice of the Future (APF) and Short White Coat blogger. The APF focuses on empowering patients to be more engaged and involved in their health care by placing the patient at the very center of the care team. Ishani was drawn to APFs model of innovation and desire to understand the whole patient over a period of time. During our conversation with Ishani, we will hear how the APF is changing the future of primary care through technology, space and processes, and how shared decision making plays a role at the practice. Continue reading
American College of Physicians Endorses Shared Decision Making Approach for Prostate Cancer Screening
In a guidance statement published Tuesday in the Annals of Internal Medicine, the American College of Physicians (ACP) joined the heated discussion on PSA testing by endorsing a shared decision making approach for prostate cancer screening. The ACP Clinical Guidelines Committee developed this guidance statement after reviewing current guidelines on prostate cancer screening in the U.S.
To this end, a shared decision making approach is appropriate for decisions about prostate cancer screening due to the preference-sensitive nature of the decision. We believe it is imperative that patient preferences be incorporated in the decision-making process and applaud the ACP for supporting a shared decision making approach for decisions about prostate cancer screening. By having an informed conversation about a diagnostic tool and disease that is often poorly understood, men can feel confident that they’ve made the decision that’s right for them. Continue reading
Shared Decision Making Month Comes to a Close: A Personal Thank You to All Those Who Participated
I’d like to start by thanking everyone who has contributed to Shared Decision Making (SDM) Month. We’ve been overwhelmed by the support of this initiative. During the month of March we have heard from roughly 50 contributors representing a variety of perspectives on how fostering a health care system where shared decision making is the norm, is critical. We have also heard time and again that shared decision making is essential to providing patients with the high-quality care that patients deserve. However, contributors have also shown that the complex and fragmented nature of health care systems can make it difficult to take shared decision making theory and turn it into meaningful and sustainable everyday practice. Continue reading
The Veterans Administration Makes Shared Decision Making Resources Available to Help with Long Term Care Choices
Being informed and involved in medical decisions about long term care choices is critically important for older patients. The Guide to Long Term Care is now the core of the Veterans Administration’s Geriatrics and Extended Care website, partly in response to the needs of the growing number of aging Veterans – of the nation’s 23 million Veterans, almost half are over 65. Continue reading
The Road Less Traveled: A Personal Decision to Choose Active Surveillance
In June 2008, as part of my annual physical at age 61, my physician gave me a digital rectal exam. He felt a lump on my prostate that he felt needed further evaluation so he referred me to an urologist. The urologist performed a biopsy, which showed prostate cancer in two out of the twelve cores tested, with 10% cancer in each core and a Gleason score of 6. A Gleason 6 indicates a slow growing cancer. The urologist told me that I needed treatment and that since I was relatively young and healthy my choice could be surgery or radiation. His thinking was not whether I needed to be treated in the first place, but only what treatment would be best. He suggested I see a surgeon and radiologist to decide. Continue reading
Choosing Wisely®: Thank Goodness Patients Aren’t What They Use to Be!
The patient-physician relationship of yore was pretty much one-sided. Physicians used to tell their patients what tests and procedures needed to be done and didn’t really offer much information on their condition, nor were patients asked to be involved in decisions regarding their own care. That relationship has begun to dramatically change; patients want and are given more information, and they are more involved. There is a growing body of research that points out the benefits of patient engagement. There is more information flowing from physician to patient; patients are now seen as an excellent source of information when taking their history and their preferences are carefully considered – “nothing about me without me.”
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Shared Decision Making Policy and Decision Quality Wrap-up and a Preview of Patient Engagement Week
Week three of Shared Decision Making (SDM) Month was quite educational as we explored shared decision making policy efforts in the U.S., as well as measures of decision quality. Our tweet chat on Tuesday examined a number of shared decision making policy issues from liability to informed consent to incentives for providers. On Tuesday night we gathered in Boston for a special screening of the new documentary, Escape Fire: The Fight to Rescue American Healthcare. Shannon Brownlee, who is featured in the film, stopped by to answer our burning questions about the current state of health care in the U.S. During Wednesday’s webinar, we heard from individuals involved with projects resulting from federal and state shared decision making legislation. Thursday’s webinar provided us with insight on developing and implementing decision quality measures. Continue reading
The 2013 International Shared Decision Making Conference: Bringing Shared Decision Making South of the Equator
Preparation is well underway for the seventh International Shared Decision Making (ISDM) Conference, which will be hosted for the first time in South America. The much-anticipated event will take place in Lima, Peru June 16-19, 2013. Arguably the premier conference in shared decision making, ISDM brings together thought leaders in the field of shared decision making and those just beginning their work in the field. Researchers, patients, providers, and policy makers will gather to discuss how to globalize shared decision making while keeping patients at the very heart of health care. Continue reading
