To learn how patients describe the decision-making process for 10 common medical decisions, Fowler and colleagues surveyed a national sample of more than 2500 adults 40 years or older. They measured patients’ perceptions of the extent to which the pros and cons of the interventions were discussed with their physicians, whether the patients were told they had a choice, and whether the patients were asked for their input. Of these 10 decisions, the reported decision-making processes were the most patient centered for surgery for back or knee pain and the least for breast and prostate cancer screening. Discussions about these common tests, medications, and procedures as reported by patients do not reflect a high level of shared decision making, particularly for 5 of the decisions most often made in primary care. In a commentary, Lipkin discusses shared decision making.