When Shared Decision-Making Leads to Patient Injuries

In the past, patients commonly accepted their doctor’s recommendations about which treatment was right for them. In the past few decades, however, American healthcare providers have embraced shared decision-making (SDM) as one of their guiding principles. This philosophy encourages a collaborative process between patients and healthcare providers.

SDM enables patients to take an active role in their care rather than blindly following their healthcare providers’ directions. It expects providers to thoroughly and completely explain care options, risks, and alternatives to patients, including those that may have lower chances of success. Ideally, this process enables patients to make informed choices that align with their values and health objectives.

When both patients and healthcare professionals share the responsibility for making the best decisions, patients may be more likely to follow through with the treatments they’ve agreed upon. However, when doctors fail to properly inform patients about the risks, benefits, and alternatives available to them, shared decision-making can devolve into medical negligence.

What Shared Decision-Making Should Look Like

In a proper shared decision-making process, healthcare professionals provide patients with clear and understandable information about their condition and treatment options. This increases patient autonomy, letting them make fully informed decisions that fit their lifestyle, budget, and overall health goals.

Effective SDM includes taking steps like:

• Clearly explaining each treatment option, including its benefits, risks, and likely outcomes.
• Using clear and understandable language and verifying that the patient truly understands the information.
• Listening to and responding to the patient’s questions, respecting their concerns, and addressing their preferences.
• Honoring the patient’s right to decline or request additional opinions.

The two-way communication involved in SDM builds trust, helps patients make informed, healthy choices, and can increase their engagement in their treatment plans. A patient and doctor should discuss the risks and benefits of each approach, consider the patient’s preferences, and make a decision together.

For example, imagine a patient with high blood pressure. Effective SDM might include discussing the potential benefits and risks of different treatment options, such as medication, lifestyle changes, and surgery. They may talk about whether the patient can afford medication throughout their lifetime and how that may increase the risks of other complications. They may discuss whether taking time off to recover from surgery would be feasible and what kind of family support they would have during that time. Weighing the risks of conservative management and lifestyle changes, they might decide to pursue less invasive options and schedule a follow-up visit to re-evaluate their condition in a few months.

How Poor Communication Can Lead to Patient Harm

Effective SDM involves intense collaboration between providers and patients. Unfortunately, modern medical systems can prioritize efficiency over taking extra time for in-depth patient care. This can lead to breakdowns in the SDM process. These breakdowns may constitute medical negligence if they lead to patient injury or harm. SDM failures that may constitute negligence include:

• Failure to disclose risks. A doctor may encourage a procedure or course of treatment without fully explaining its potential complications or long-term effects. Effective SDM includes making sure patients understand the risks of going forward, as well as those involved in not proceeding for every potential treatment option.

• Minimizing patient concerns. A provider might dismiss a patient’s hesitation or symptoms as unimportant, leading to delayed diagnosis or inappropriate treatment. For example, if a patient says they are in unusual pain after surgery and the provider fails to investigate, the patient could suffer preventable harm.

• Incomplete or biased information. Some physicians may recommend a particular treatment (such as surgery) and omit viable alternatives with less chance of immediate success (such as an extensive course of physical therapy). This deprives patients of making a truly informed choice.

• Failure to obtain informed consent. Informed consent is an ongoing discussion. Providers must ensure patients fully understand and consent to each step of their treatment plan.

To effectively utilize SDM, healthcare providers must actively engage with patients and take steps to minimize the likelihood of adverse outcomes.

Promoting Better Outcomes and Avoiding Negligence

Healthcare providers must take the time to ensure every patient receives balanced, complete, and accurate information about their options throughout the SDM process. This may include using “decision aids” like diagrams, videos, and written materials to improve understanding. They should also encourage second opinions or follow-up discussions to ensure a collaborative care plan meets the patient’s goals and values. All these discussions should be well-documented in the patient’s medical record.

Healthcare systems and organizations can promote effective SDM through treatment guidelines, incentives, and resources. They must equip their employees with the skills and knowledge to facilitate SDM. This may mean increasing the time each provider spends with patients, increasing staffing levels, or implementing additional communication systems.

When Shared Decision-Making Leads to Negligence

Shared decision-making is a patient-centered approach to healthcare that empowers patients and healthcare professionals to collaborate on informed, individualized decisions about patient care. If you or a loved one were injured because your provider did not adequately explain your treatment options or risks, a medical malpractice lawsuit may allow you to hold them accountable.

In Michigan, patients who suffer injuries because their doctors did not uphold the duty to inform or respect their choices fully may be entitled to seek compensation for medical expenses and other damages through a medical malpractice claim. The experienced medical malpractice attorneys at Sommers Schwartz, P.C., can help you understand your rights and options. Contact us today for a free, no-obligation, confidential consultation.