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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.
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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.

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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.
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