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Shared Decision Making in Psychiatry
by
Erick H. Cheung, M.D.

Around 20 years ago, major health policy and clinical institutions began calls for “shared decision making” as a standard of practice in medicine (1,2,3). Barry, in a 2012 NEJM article, described shared decision making as “The Pinnacle of Patient Centered Care” (4). The Institute of Medicine, in their seminal report Crossing the Quality Chasm, described a future of medical care “that is respectful and responsive to individual patient preferences, needs, and values… [ensuring] that patients values guide all clinical decisions.” In 2010, experts from 18 countries issued a formal statement calling for physicians to recognize shared decision making as an ethical imperative (5).

The term shared decision making (SDM), while seemingly intuitive, was not one that I was explicitly familiar with. It was not something that I was “taught” in my years of formal medical education. This term came to my attention as I began investigating ways to improve the patient experience (AKA “patient satisfaction”) in the inpatient hospital setting. It turns out that a patient’s experience of sharing in the decision-making about their care is one of the strongest drivers of overall satisfaction with their care, and there is evidence to back that up (1, 6).

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