We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Patient-Centered Decisions in Primary Care—Reply

Floyd J. Fowler Jr, PhD1,2; Bethany S. Gerstein, BA1; Michael J. Barry, MD1
[+] Author Affiliations
1Informed Medical Decisions Foundation, Boston, Massachusetts
2Center for Survey Research, University of Massachusetts, Boston
JAMA Intern Med. 2014;174(3):475. doi:10.1001/jamainternmed.2013.12843.
Text Size: A A A
Published online


In Reply It was good to read the comments of Symvoulakis and colleagues about our recent article on how decisions are made.1 To inform and involve patients in medical decisions is a goal that is valued to varying degrees around the world. It also poses major challenges for health care clinicians around the world, perhaps most acutely in primary care. The writers provide a good list of the problems: the wide variety of medical problems seen in primary care, lack of skills or practice in doing shared decision making, and physicians’ concerns that patients will not do something that they think is medically valuable. It will take some adjusting for physicians to feel comfortable when patients do not make the decisions they would recommend. However, as the writers state: “…striving toward a well-informed and actively involved patient…should become a priority for any health care reform to succeed over time.” We could not agree more.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





March 1, 2014
Emmanouil K. Symvoulakis, MD, PhD; Dimitrios Anyfantakis, MD, MSc; Adelais Markaki, APRN-BC, PhD
1Private Family Practice Unit in Heraklion, Heraklion, Crete, Greece
2Primary Health Care Centre of Kissamos, Chania, Crete, Greece
3Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
JAMA Intern Med. 2014;174(3):474. doi:10.1001/jamainternmed.2013.12878.
Also 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.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
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.


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

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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

See Also...