00:01
Alright, so that brings us to a new
model of shared decision making.
00:07
This is especially important when
it's decisions that are value laden,
that really it matters more
about the patient's value system
and their preferences about
how they might make the decision.
00:18
It's also important when
what we're proposing.
00:21
There might be two options
that seem relatively equal.
00:26
They seem to have
equal medical benefit
in terms of managing
that condition.
00:31
So there needs to be a back and
forth exchange of information
to really understand
the patient's preferences.
00:37
Use that information
to help guide them
in making what I would call
a shared decision making.
00:42
It's both the clinician
and the patient
coming to a decision
mutually together.
00:49
So it starts with
information exchange.
00:51
So things that are
personally meaningful
information for the patient.
00:55
We're exploring those,
we're trying to understand
the patient's experience,
what their expectations are.
01:02
We're trying to provide
them the evidence
that they need to understand
how they can manage their
condition, including the possibility
there might be uncertainties
along the way.
01:13
And how do they as a person
deal with uncertainty.
01:17
The second phase of shared decision
making is going to be deliberation.
01:20
So there, there's an actual
interaction of
exchanging of opinions.
01:25
So you're creating a
safe environment for them
to freely share their thoughts.
01:30
You're reacting to
what they're saying,
hopefully trying to
enhance the discussion,
so that they can reach a decision
that seems best for them.
01:42
And then lastly,
you do reach the decision.
01:44
So this is a collaboration reaching
an agreement on the treatment,
where it's going to be the
physician being transparent
of their assessment
of the situation and
why they think this
treatment might be
preferable to the alternative
treatment based on the knowledge
that they've learned from the
patient about their preferences.
02:06
Which then leads to this
issue of transparency.
02:09
So you're really trying to use
your communication skills
to give your thought process,
you're thinking about the matter,
as transparently as possible.
02:24
So you're sort of
giving the reasoning
behind the decision that you think
is going to be best for the patient.
02:29
It's only after you've
learned from them,
you know what's important to them.
02:33
So you're integrating
that information
into your reasoning process.
02:39
And why you would say, "Well,
I recommend this one
over the alternative."
Again, it's still gonna
be up to the patient
to decide if it's right for them,
but you're being
transparently open about
how you're thinking
about the situation.
02:54
And the hope is that
this mutual exchange
really gets to the goals and values
that are going to be important
for the patient in the future.
03:01
So I really see this as an
opportunity to think aloud
using language that the
patient understands,
again, to enhance their ability
to make good decisions.