Improving Patient Decision Making Through Decision Aids

Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).

"Children, young people, their parents or legal guardians, and health care professionals in all settings make decisions about medicines based on sound information about risk and benefit. They have access to safe and effective medicines that are prescribed on the basis of the best available evidence" (Caldwell, 2013).

Blendon, R. DesRoches, C. Brodie, M., Benson, J. Rosen, A., & Schneider, A. (2002). Views of practicing physicians and the public on medical errors. New England Journal of Medicine. 347, 1933-1940.

ii. Unconscious physician bias. Another theme in the reading that related back to class was the unconscious biases of doctors influence their interactions with patients, with consequences for patient outcomes. These unconscious biases affect interaction through the doctor’s communication. Establishing a basic understanding of treatment and diagnosis can foster better patient outcomes. An example of unconscious physician bias was Abraham 's focus on former secretary of the Department of Health and Human Services, Dr. Sullivan, in chapter eight. Dr. Sullivan’s campaign focused on the individual choice in adopting healthy lifestyle choices from diet to exercise. Skipping over racial disparities, the unconscious bias inferred through his words was that he considered the patient to blame whenever they fell ill.

The Atlanta-based internist is concerned with how recipients and providers of medical services receive and make health advice and recommendations, respectively. He rues the current practice of medicine, which now pays more emphasis to data or evidence: anything that the data reveals are immediately taken as hard science, with the results taken from studies that claim to “represent a consistently reliable representation of the real world of human beings” i.e., those who do not participate in the studies. For Paul, the data or studies could mean

Identify key features related to their use of the CDSS in terms of: the type of CDSS they use (knowledge based, or analytics, or a combination of both), its usability (ease of use), utility (perceived usefulness), how they incorporate it into their own workflow, what are some of its features, its overall impact on any patient outcomes and any challenges they have experienced while using the CDSS.

Considerable evidence demonstrates the clinical effectiveness and potential cost reduction associated with shared decision making. A review by the Cochrane Collaborative published in 2014 evaluated 115 randomized control trials with 34,444 participants for the effectiveness of decision aids for persons facing treatment or screening decisions. The data demonstrate use of decision aids results in better than usual care in several quality domains. Namely shared decision making had a positive effect on patient knowledge, communication with the health care provider, improved patient engagement in the decision making process and provided more realistic outcome expectations. Interestingly, decision aids were also

Informed consent is commonly obtained from patients for medical treatment procedures and protocols. While it may serves as a litigated protection and assurance for healthcare professions to confidently perform their duties as healthcare providers, informed consent also ensures patient’s understanding and acknowledgement of their involvement in multiple medical interventions pertaining to their health. As the patient sign these consent documents, they might be unaware of the existence of uncertainty in medical practice. Medicine is the evident of probability because we are not physiologically created equal. Therefore, medical uncertainty is inevitable and physicians have to face tough choices to make a decision they believe to be in patient’s

In the first hour of today’s lecture, Dr. Schommer introduced today’ topic by an interesting exercise. Actually my English is not that fluent, so I know how difficult it is for a foreigner to understand Americans thoroughly. Regarding patient experience, health care providers should make medication and therapy decisions with the patients equally, and, what is more important is to consistent of the decisions and follow up.

A study carried out last year showed 82% of doctors said they had prescribed or carried out a treatment which they knew to be unnecessary. The main reason being patient pressure or patient expectation. Choosing Wisely is a global initiative to tackle this and reduce over-medicalisation. the initiative aims to advise doctors and patients to have a more informed conversation about the risks and benefits of all treatments and procedures. The initiative could lead to patients getting a better outcome from an illness and treatment while saving the NHS billions.

Patient's decision-making is influenced by several factors. Patients may change their decisions, from accepting or refusing treatment depending on the available treatment options. The capacity of the individual to make informed medical decisions can differ as the patient's status changes cognitively, emotionally, and/or physically and as the proposed treatment interventions change. Treatment refusal is a common situation faced by clinicians. Patients do not usually refuse the medical advice if the advice is of good intention. When patients refuse an advice, it indicates some underlying reasons related to the patients or family, factors associated with the physician as well as social and organizational issues.

The case study given is a classic case where a patient’s belief, (real, false interpretation of facts) influences their behavior and is a barrier to receiving quality and/or appropriate care. The ladder of influence and its steps will show how ones “beliefs, accurate or not, affect quality of care received, and the importance of health care providers to dispel any misconceptions a patient may possibly have. The subject in this case study “Mia” jumped to the wrong conclusions. This short paper will use the

Pearson (2013) clarifies “clinical decision making is essential to every aspect of care delivered to a patient” (p. 214). It is the ability to blend information and make decisions that will later be implemented in the situation. Evidence-based decision making involves choosing from a variety of possibilities and combining the knowledge through research and the scientific evaluation of one’s practice. The purpose of this paper is to analyze my decision of administering ativan by advocating for the patient and anticipating her change prior to confirming signs; which provided a therapeutic response.

Navigating uncertainty is something I'm prepared to do daily when I become a physician. The patients treated by physicians are where I think the most uncertainty comes in and navigating the uncertainty with each patient is whats most important. Old and new patients come in daily with problems, needs, and prior medical experiences, and put their trust into the hands of the physician. Every interaction is unique, so making sure each person gets the best medical care possible can be challenging. Being uncertain of the correct diagnosis, uncertain the course of treatment is the most effective and safe, and uncertain that a patient's emotional and mental needs are being adequately met are things faced by physicians constantly. By treating every

Patients in the United States have a right to refuse care if treatment is being recommended for non-life-threatening illnesses according to the Washington School of Medicine (2012). The simple task of refilling a prescription, or choosing to not get a flu shot are all acts of not following through with treatment mechanisms. Patients often times refuse medical treatment for far more reasons than just religious beliefs. Subconscious emotion reasons about side effects, pain, healing time, and the procedure itself scares patient’s away (Washington School of Medicine, 2012).