Shared decision-making: Doctors must welcome and not resist patients' questions

Over the years, her view of the patient who asks lots of questions has changed, says Anna Reisman, M.D., in a guest column on CommonHealth.

Reisman, an associate professor at Yale School of Medicine, says in her early years as a primary care doctor she didn't mind questions from patients but hated the feeling that they were challenging her recommendations and wished they would just accept what she was telling them at face value.

Now as a middle-aged doctor with 15 years of practice, her view has changed, in large part, she says, from having been on the other side where she has questioned her own and family members' doctors. "I expect them to be willing to engage in conversation, answer my questions and provide good reasoning. I can't imagine accepting everything that a doctor tells me with nary a raise of an eyebrow. And so now, when my patients tell me that they've Googled their symptoms or read about some new approach on Facebook, I no longer cringe; I welcome their input," she says.

Resiman says she can empathize when she hears from her medical students that they just wish their patients would stop being "difficult" and asking all those questions. She points out there is a difference between difficult and "assertive" and it is good when patients and family members say what is on their minds and not just accept every recommendation. Patients are now part of the shared decision-making process, Reisman says, and those assertive patients have better health outcomes.

Reisman's view of the doctor-patient relationship is in line with the healthcare industry, which has increasingly become aware of the value of shared decision-making in effective patient care. Doctors are urged to help educate patients and walk them through their available options.

Patients are increasingly coming to expect a collaborative relationship with their healthcare providers, as FiercePracticeManagement previously reported. They are less likely to stay with physicians they perceive as dismissing, criticizing or belittling their input. 

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