title: 'That's the doctor's job': Overcoming patient reluctance to be involved in medical decision making.
abstract: To review the barriers to patient engagement and techniques to increase patients' engagement in their medical decision-making and care.
  
  
  
  Barriers exist to patient involvement in their decision-making and care. Individual barriers include education, language, and culture/attitudes (e.g., deference to physicians). Contextual barriers include time (lack of) and timing (e.g., lag between test results being available and patient encounter). Clinicians should gauge patients' interest in being involved and their level of current knowledge about their condition and options. Framing information in multiple ways and modalities can enhance understanding, which can empower patients to become more engaged. Tools such as decision aids or audio recording of conversations can help patients remember important information, a requirement for meaningful engagement. Clinicians and researchers should work to create social norms and prompts around patients asking questions and expressing their values. Telehealth and electronic platforms are promising modalities for allowing patients to ask questions on in a non-intimidating atmosphere.
  
  
  
  Researchers and clinicians should be motivated to find ways to engage patients on the ethical imperative that many patients prefer to be more engaged in some way, shape, or form; patients have better experiences when they are engaged, and engagement improves health outcomes.
authors.affiliation: Baylor College of Medicine, Center for Medical Ethics & Health Policy, One Baylor Plaza, MS: BCM 420, Houston, TX, USA. Electronic address: Jennifer.Blumenthal-Barby@bcm.edu.
authors.forename: J S
authors.initials: JS
authors.lastname: Blumenthal-Barby
mesh_terms: D001291:Attitude of Health Personnel; D000066491:Clinical Decision-Making; D003142:Communication; D003144:Communication Barriers; D003469:Culture; D003657:Decision Making; D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000379:methods; D057220:Health Literacy; D006801:Humans; D010358:Patient Participation / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods*; D010819:Physician's Role; D010817:Physician-Patient Relations
keywords: Patient engagement; Physician-patient communication