THE AFFORDABLE CARE ACT will lead to many administrative changes in how Americans receive and pay for health care, that is clear. But embedded within the vast and complex legislation is also a call for a transformation in how you and your doctors interact: Doctors are now encouraged to talk to you differently, to fully explain your medical options, and to collaborate when there are difficult decisions to be made about treatment. This process is known by the cumbersome term “shared decision making.”
Unless you’ve attended medical school, this scenario might sound frightening. Patients often want their physicians to understand what matters to them, make good recommendations, but keep decisional responsibility. Most patients probably do not consider themselves health care decision makers — nor do they want to be. They worry about the responsibility the process confers, or anticipate regret if they end up making the “wrong” decision. We know reform is asking us to take a more active role in our health, but for many patients shared decision making is a step too far, as if the professional healer is abrogating her role as expert guide.