Providers can involve patients by making clear when a choice exists, explaining reasonable options in understandable language, asking what matters most to the patient, and agreeing on next steps together. This collaborative process is often called shared decision-making. It combines the best available clinical evidence and the clinician’s expertise with the patient’s preferences, goals, and circumstances.
What shared decision-making means
Shared decision-making is especially useful when more than one reasonable option exists and the trade-offs may matter differently to different people. Options can include different tests or treatments, watchful waiting, or—in some situations—no immediate action. It does not mean that a clinician transfers all responsibility to the patient or that every preference can override clinical safety. The goal is an informed, respectful decision suited to the individual situation.
The AHRQ SHARE approach: five practical steps
- Seek the patient’s participation. Say that a decision is being considered and ask how involved the patient would like to be. Example: “There are a few reasonable approaches. Would you like us to compare them and decide together?”
- Help compare options. Describe the benefits, risks, uncertainties, burdens, and likely next steps for each clinically appropriate option. Include the option of waiting or taking no action when appropriate. Use a decision aid when a suitable, evidence-based one is available.
- Assess values and preferences. Ask what outcomes matter most, what concerns the patient has, and what practical factors—such as work, caregiving, transportation, cost, language, or accessibility—could affect the plan.
- Reach a decision together. Check understanding, answer questions, and make a recommendation when helpful. Agree on the choice, or identify what information or time is needed before deciding.
- Evaluate and follow up. Document the discussion and plan, explain who will do what next, and set a time or trigger to revisit the decision if the patient’s situation or preferences change.
Communication techniques that support participation
- Use plain language and explain medical terms; offer a qualified interpreter when needed rather than relying on a child or an unqualified companion.
- Present options in a balanced way. Avoid framing that pressures the patient toward the clinician’s preferred choice.
- Use teach-back as a check on how clearly information was explained: invite the patient to describe the plan in their own words, then clarify gaps without blame.
- Offer time to reflect or involve a support person if the patient wants one and privacy allows.
- Ask what format would help: verbal explanation, written summary, visual aid, accessible digital content, or another communication accommodation.
- Respect a patient’s choice not to make a decision immediately or not to take an active role, while ensuring they understand how to ask questions later.
Example: discussing two treatment options
A clinician might explain: “Both options are reasonable for your situation. Option A may involve [relevant benefit] and [relevant risk or burden]. Option B may involve [different benefit] and [different risk or burden]. We can also discuss waiting or another approach if that is clinically appropriate. What matters most to you as we compare them?” The clinician should fill in this conversation with accurate, patient-specific information—not generic or invented percentages.
