Caring for patients involves the formation of multiple opinions. Traditionally, the patient's physician generates the first opinion, with other clinicians offering second opinions. However, an opinion at least as important must also be recognized in this traditional rubric—that of the patient and family members. Just as the conscientious health care practitioner is constantly reformulating his or her opinion based on many factors, so too is the patient.
Facilitating patients' development of well-informed opinions is of key importance to the health of individuals and the nation. An emerging literature indicates that patients actively involved in their own health care have better outcomes, are more satisfied with their choices, and may make more cost-effective decisions.1,2 Active involvement can take many forms; one of the most important is facilitating decision making when options exist. An evidence-based process for eliciting the patient's informed opinion occurs through shared decision making in which 3 elements are equally brought to bear: the medical evidence, the clinician's expertise, and the patient's goals and concerns.
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