Decision making in health care is very complex. Do you make a decision based on recommendations from your surgeon? Do you make decisions based on what you read online? Are the decisions based on your values and expectations? Below I have given you a starting point to begin your process. The same treatment might not be appropriate for all patients. Given the same facts, and potential outcomes from surgery, your decision to proceed with orthopedic surgery is likely different than other patients in that same office with the same injury.
An interesting tool available to you is from the Mayo Clinic… they have started to compile a number of shared decision making tools to assist in communicating with your doctor. Click here to access the Mayo Clinic site.
Shared decision making (SDM) actively involves YOU, the patient, in the surgical decision making process. After the facts about your injury or condition have been explained, we will discuss a range of treatment options, and the results that you should consider in light of those options.
Your values, including the impact on your quality of life, will become the focus of this process, instead of having a physician dictate to you which option is best.
Patients know more about their health and their lifestyle and their physical limitations and goals than what physicians have traditionally given them credit for. That’s what Shared Decision Making is all about, and this section of my website will help provide you with some of the tools and information you need to work through the SDM process. I hope it will help you with the information to determine whether surgical or non-surgical options best suit your particular needs.
Second Opinions: Principles of Shared Decision Making
The “Personality of an Injury”
Example #1: A 40-year-old who plays tennis five days a week and has a rotator cuff tear may choose a different option for treatment than a 78-year-old sedentary person with limited demands on the shoulder.
Example #2: An 18-year-old football player who wants to play ball in college may choose to have his Anterior Cruciate Ligament (ACL) tear reconstructed surgically. But a 30-year-old working mother may choose to just alter her level of activity rather than having surgery.
Each injury has its own “personality.” The same injury will not affect different individuals — with different needs and lifestyles — in the same way. Therefore the same treatment might not be appropriate for different individuals.
We should be treated as patients, and not a collection of our images and MRI findings. Find a physician who is will to listen to you and engage you about the choices that you have, and assist you in making an informed choice based on your values, and your expectations.
Shared Decision Making Tools
- Ottawa General Decsion Making Aid
- ACL Reconstruction surgical decision aid
- Rotator Cuff Repair surgical decision aid
- Knee Replacement Surgical Decision Aid
- Achilles Tendon Repair Surgical Decision Aid
