Three Models for Shared Healthcare Decisions
07 Jun 2017
Patients who are supported to truly actively participate in selecting their treatment are more likely to make decisions that are best for them.1
It’s always a good time to think about how you’re going to provide patient-centred care. Patient centeredness is a fundamental component of healthcare delivery.
MDA National outlines three models of shared decision-making – a consultation process where both the doctor and patient make a health decision together after talking about the benefits and risks of treatment options, and what the patient values, their preferences and life circumstances.1
MODEL 1: Five Questions
The doctor personalises the choice for the patient and ensures the patient has enough information to make a decision by asking the patient five questions:
Figure 1.The five-question model helps doctors guide patients towards making an informed healthcare decision.1
Figure 2. When considering the order in which to present risks it is recommended to spend most time on 1) serious and common risks, followed by 2) serious and rare, 3) minor and common, and 4) minor and rare.
See mja.com.au/system/files/issues/201_01/hof00002.pdf for more information on the five-question model.
MODEL 2: Three Steps
The doctor helps the patient improve their knowledge and form preferences to make an informed decision.
Figure 3. The three-step model is a sequential process that encourages discussion, reflection, weighing up of options and reconsidering information. Used with permission from Prof Glyn Elwyn 2016.2
MODEL 3 – Ask, Share, Know
The patient leads the process to make a healthcare decision (“No decision about me, without me”).
Figure 4. Ask, Share, Know encourages the patient to lead the decision-making process in three main ways. 3
See askshareknow.com.au for more information on this approach.
Want more detailed information on these models and informed consent?
Our online education activity Informed Consent Challenges is available
to Members now.
MDA National Education Services
References
- Hoffmann T, Legare F, Simmons M, McNamara K, McCaffery K, Trevena L, et al. Shared Decision Making: What Do Clinicians Need to Know and Why Should They Bother? Med J Aust. 2014;201(1):35–9. Available at: mja.com.au/journal/2014/201/1/shared-decision-making-what-do-clinicians-need-know-and-why-should-they-bother.
- Elwyn G. Collaboration Talk Model for Shared Decision Making. 21 July 2015 [cited 29 June 2016].
- Ask Share Know. [cited 6 January 2016]; Available at: askshareknow.com.au/
My Career Journey with Dr Nick Coatsworth
Dr Nick Coatsworth is an expert in health policy, public administration and a practising infectious diseases physician. He held a national role in the Australian response to COVID-19 as Deputy Chief Medical Officer of Australia, becoming one of the most recognised medical spokespeople during the pandemic. Nick engaged the Australian community through a variety of media platforms most notably as the spearhead of the national COVID-19 vaccination campaign. Dr Micheal Gannon, Obstetrician & Gynaecologist, sits down with Dr Nick Coatsworth to discuss Nick's medical career journey, and what insights and advice he has for junior doctors. MDA National would like to acknowledge the contributions of MDA National staff, Members, friends and colleagues in the production of the podcast and note that this work is copyright. Apart from any use permitted under applicable copyright law, you may not reproduce the content of this podcast without the permission of MDA National. This podcast contains generic information only, is intended to stimulate thought and discussion, and doesn’t account for requirements of any particular individual. The content may contain opinions which are not necessarily those of MDA National. We recommend that you always contact your indemnity provider when you require specific advice in relation to your insurance policy or medico-legal matters. MDA National Members need to contact us for specific medico-legal advice on freecall 1800 011 255 or email advice@mdanational.com.au. We may also refer you to other professional services.
09 Jun 2022
Career complications and contending with uncertainty
Among the many challenges of the COVID-19 pandemic for junior doctors is how to respond to medical training impacts and career uncertainty. In this podcast, Dr Caroline Elton (a psychologist who specialises in helping doctors)and Dr Benjamin Veness (a Psychiatry registrar) share advice for coping with medical training and career delays, disruptions and unknowns.
10 Aug 2020
