--- title: "Physicians' perceptions of shared decision-making behaviours | Sutter Health" description: "Study sample showed that many supported shared decision making but held inconsistent beliefs. More training is needed." url: "https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Physicians' perceptions of shared decision-making behaviours # Physicians' perceptions of shared decision-making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice. Zeuner R, Frosch DL, Kuzemchak MD, & Politi MC. _Health Expect. 18(6):2465-76. doi: 10.1111/hex.12216. Epub 2014 Jun 17._ 2015-12-01 ## Abstract BACKGROUND: Shared Decision Making (SDM) is a process of engaging patients in health decisions that involve multiple medically appropriate treatment options. Despite growing public and policy support for patient engagement in health decisions, SDM is not widely practiced in clinical settings. OBJECTIVE: The purpose of our study was to explore clinicians' attitudes, beliefs and perceived social norms about engaging in SDM behaviours. DESIGN: Semi-structured qualitative interviews were conducted with physicians in five practice areas. SETTING AND PARTICIPANTS: This study was conducted at an academic medical centre in St. Louis, MO. The final sample included 20 physicians: five surgeons, five OB/GYNs, four medical oncologists, five internists and one emergency medicine physician. RESULTS: Clinicians described a number of beliefs and cultural- and system-level obstacles to the widespread implementation of SDM, such as how to engage in discussions of cost, uncertainty and clinical equipoise and how to engage patients across various socioeconomic backgrounds. CONCLUSION: Although a large number of participants expressed general support for incorporating SDM into practice, most held fundamentally inconsistent beliefs about practicing specific SDM behaviours. More extensive training of physicians at all levels (pre- and post-licensure) can help increase clinicians' confidence in SDM skills. Developing methods of integrating SDM into the institutional framework of hospitals and training programmes could also increase clinicians' motivation to practice SDM and work to change the culture of medicine such that SDM behaviours are supported. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/24938120) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/risk-benefit-contralateral-prophylactic-mastectomy-1055312871) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. pii: 1049732314557085. \[Epub ahead of print\] 2014 Nov 04 - Publication ### [Linking electronic health records to better understand breast cancer patient pathways within and between two health systems.](https://www.sutterhealth.org/research/publications/link-ehrs-understand-breast-cancer-pathways-1055312796) Thompson CA, Kurian AW, Luft HS. eGEMs (Generating Evidence & Methods to improve patient outcomes). 3(1). 2015 Mar 01 - Publication ### [Mapping the decision-making process for adjuvant endocrine therapy for breast cancer: the role of decisional resolve.](https://www.sutterhealth.org/research/publications/decision-making-adjuvant-endocr-tx-breast-ca-1055312417) Beryl LL, Rendle KA, Halley MC, Gillespie KA, May SG, Glover J, Yu P, Chattopadhyay R, Frosch DL. Med Decis Making. pii: 0272989X16640488. \[Epub ahead of print\] 2016 Apr 06 - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/decsion-for-contralateral-prophylactic-mastectomy-1055312294) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. 25(9):1251-9. doi: 10.1177/1049732314557085. Epub 2014 Nov 4. 2015 Sep 01 - Publication ### [Tradeoffs of using administrative claims and medical records to identify the use of personalized medicine for patients with breast cancer.](https://www.sutterhealth.org/research/publications/identify-use-of-personalized-med-in-breast-cancer-1055312577) Liang SY, Phillips KA, Wang G, Keohane C, Armstrong J, Morris WM, Haas JS. Med Care. 49(6):e1-8. doi: 10.1097/MLR.0b013e318207e87e. 2011 Jun 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Physicians' perceptions of shared decision-making behaviours"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533#medicalscholarlyarticle","name":"Physicians' perceptions of shared decision-making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice.","headline":"Physicians' perceptions of shared decision-making behaviours","abstract":"BACKGROUND: Shared Decision Making (SDM) is a process of engaging patients in health decisions that involve multiple medically appropriate treatment options. Despite growing public and policy support for patient engagement in health decisions, SDM is not widely practiced in clinical settings. OBJECTIVE: The purpose of our study was to explore clinicians' attitudes, beliefs and perceived social norms about engaging in SDM behaviours. DESIGN: Semi-structured qualitative interviews were conducted with physicians in five practice areas. SETTING AND PARTICIPANTS: This study was conducted at an academic medical centre in St. Louis, MO. The final sample included 20 physicians: five surgeons, five OB/GYNs, four medical oncologists, five internists and one emergency medicine physician. RESULTS: Clinicians described a number of beliefs and cultural- and system-level obstacles to the widespread implementation of SDM, such as how to engage in discussions of cost, uncertainty and clinical equipoise and how to engage patients across various socioeconomic backgrounds. CONCLUSION: Although a large number of participants expressed general support for incorporating SDM into practice, most held fundamentally inconsistent beliefs about practicing specific SDM behaviours. More extensive training of physicians at all levels (pre- and post-licensure) can help increase clinicians' confidence in SDM skills. Developing methods of integrating SDM into the institutional framework of hospitals and training programmes could also increase clinicians' motivation to practice SDM and work to change the culture of medicine such that SDM behaviours are supported.","description":"Study sample showed that many supported shared decision making but held inconsistent beliefs. 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