Editor's Correspondence |

Physicians Recommend Different Treatment for Patients Than They Would Choose for Themselves

David Alfandre, MD
Arch Intern Med. 2011;171(18):1685. doi:10.1001/archinternmed.2011.457.
Text Size: A A A
Published online


In their article, Ubel et al1 have provided additional data to assist physicians in helping patients make better health care decisions. While their results are unambiguous, the authors' conclusions may benefit from further consideration. Their methodology described physicians providing a recommendation based on a fixed set of circumstances relating to the risks, benefits, and alternatives of a particular intervention. Although the authors mentioned that “the best choice . . . depends on the relative value a given patient places on avoiding these complications vs reducing his or her chance of death,”1(p631) they did not include or account for this critical element of the shared decision-making process, that is, eliciting a patient's values.2,3 Shared decision making is a process of “decisions that are shared by doctor and patient and informed by best evidence, not only about risks and benefits but also about patient-specific characteristics and values.”4(p766) Their methodology leads to a physician recommendation that is made in the abstract rather than one based on a patients relevant values. This article may help to illustrate what is so important about the ideal of shared decision making—that a failure to elicit a patients values results in recommendations that more reflect what a physician would choose for themselves rather than what their patients want.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
PubMed Articles