As a GP trainee preparing to sit the MRCGP SCA, you might view Shared Decision Making (SDM) as just another checkbox. However, SDM is far more than a procedural requirement—it’s a transformative approach that enhances patient care and outcomes significantly.
The Evolution from Paternalistic to Collaborative Care
Gone are the days when doctors acted as all-knowing oracles, dictating treatment plans without patient input. Nowadays, patients are active partners in their health journeys. Understanding the spectrum of decision-making models—from paternalistic to informed to shared—is crucial. SDM stands out as it combines the expertise of the doctor with the personal insights of the patient, making it a balanced and effective approach.
The Advantages of Shared Decision Making
SDM brings numerous benefits, such as enhanced patient satisfaction, improved health outcomes, and cost-effectiveness by aligning treatments with patients’ desires, leading to better adherence and overall outcomes. Such collaborative practices are not only rewarding but are shaping the future of personalised healthcare.
Addressing the Challenges
While SDM is the ideal model in many scenarios, it’s not universally applicable. Certain situations, such as emergencies or when dealing with particular medical conditions, might require more directive decision-making from the doctor. Trainees must learn to assess when to apply SDM and when to take a more decisive stance, ensuring they manage patient expectations and anxiety effectively.
Implementing SDM in Your Practice
To effectively implement SDM, consider the three-talk model:
- Information Exchange: Engage in a thorough discussion where both patient and doctor share relevant information about treatment options, with the doctor explaining the potential benefits and risks.
- Deliberation: Together, deliberate over the options, taking into account the patient’s values, preferences, and lifestyle.
- Decision: Make a joint decision that aligns with the patient’s best interests and health goals.
Overcoming barriers in these stages might include strategies like using decision aids to help explain complex information, or role-playing exercises to practise engaging reluctant patients.
Case Example
Consider Dr Sarah, a GP discussing treatment options with a patient newly diagnosed with type 2 diabetes. Instead of deciding to start medication for the patient, Dr Sarah outlines lifestyle changes and medication options. By incorporating the patient’s personal goals and concerns into the decision-making process, they collaboratively decide on a treatment plan that suits the patient’s daily life and long-term health objectives.
The ability to effectively collaborate with patients in treatment decisions is vital. Take every opportunity during your training to practise SDM, whether through simulations or real clinical interactions. This hands-on experience will build your confidence and proficiency, truly equipping you to foster deeper patient relationships and deliver care that respects patient autonomy and preference.
How did this IMG pass MRCGP SCA?
After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.
