Envisioning Shared Decision Making: A Reflection for the Next Decade
MDM Policy & Practice, vol. 5, pp. 2381468320963781
Abstract
Despite the evolving evidence in favor of shared decision making (SDM) and of decades-long calls for its adoption, SDM remains uncommon in routine care. Reflecting on this lack of progress, we sought to reimagine the future of SDM and the path to take us there. In late 2017, a multidisciplinary and international group of six researchers were challenged by a senior SDM scholar to envision the future and, based on a provocatively critical view of the present, to write letters to themselves from the year 2028. Letters were exchanged and discussed electronically. The group then met in person to discuss the letters. Since the letters painted a dystopian picture, they triggered questions about the nature of SDM, who should benefit from SDM, how to measure its contribution to care, and what new ways can be invented to design and test interventions to implement SDM in routine care. Through contrasting the purposefully generated dystopias with an ideal future for SDM, we generated reflections on a research agenda for SDM. These reflections hinged on recognizing SDM's contributing to care, that is, as a way to advance the problematic human situation of patients. These focused on three distinct yet complimentary contributors to SDM: 1) the process of making decisions, 2) humanistic communication, and 3) fit-to-care of the resulting decision. The group then concluded that to move SDM from envisioned to routine practice, and to ensure it reaches all, particularly persons rendered vulnerable by current forms of health care, a substantial investment in implementation research is necessary. Perhaps the discussion of these reflections can contribute to a path forward that will improve the likelihood of the future we dream for SDM.
Authors 7
-
Jennifer L. Barton corresponding
Oregon Health & Science University · VA Portland Health Care System
Affiliation as printed
Oregon Health & Science University, Portland, Oregon
VA Portland Health Care System, Portland, Oregon
-
Mayo Clinic · Leiden University Medical Center
Affiliation as printed
Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
-
Affiliation as printed
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
-
Mayo Clinic · Université Laval
Affiliation as printed
Department of Family and Emergency Medicine, Faculty of Medicine, and Research Center on Healthcare and Social Services in Primary Care, Laval University, Quebec City, Quebec
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
-
Affiliation as printed
Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
-
Affiliation as printed
Institut und Poliklinik für Medizinische Psychologie, Hamburg, Germany
-
Affiliation as printed
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
Cited by 27 stored of 28
No patents citing this paper on Lens.org (checked 2026-10-11).