Matching patient-specific expectations with physician-specific outcomes: towards transparency in treatment decision-making and consent.
This article hypothesizes that while the principles of evidence-based practice should serve as a guiding ideal for physicians, the manner in which this practice style is commonly implemented may be insufficient to the provision of truly informed decision-making and consent - especially in cases where outcomes are inextricably tied to technique, such as in the surgical subspecialities. Specifically, current methods of 'shared decision making' fail to adequately incorporate patient-specific expectations and physician-specific outcomes. A 'next-step', aimed at matching such expectations with outcomes is suggested and a method for implementation is presented.
Weiner
Bradley K
BK
Division of Spine Surgery, Texas Medical Center/The Methodist Hospital, 6550 Fannin, Suite 2500, Houston, TX 77030, USA. bkweiner@tmh.tmc.edu
D001168:Arthritis / Q000473:pathology; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006801:Humans; D007258:Informed Consent; D017116:Low Back Pain / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D008960:Models, Psychological; D009408:Nerve Compression Syndromes / Q000473:pathology; D010292:Paresthesia / Q000503:physiopathology; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D011859:Radiography; D013130:Spinal Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D013168:Spondylolisthesis / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome