Shared decision making threatened by the political agenda

19 November 2012

This article makes explicit the approach that many general practitioners feel they already aspire to, and being aware of our personal biases and cognitive processes during the consultation can only help us to become better doctors. Unfortunately, in the UK this approach is coming under increasing threat.

Despite the government’s mantra “no decision about me without me”, the reality is that with the increasing demands from performance management, GPs are under pressure to disregard patient preferences and to manage them according to strict and simplistic protocols. The proposed new GP contract threatens to intensify this. In one of the many internal tensions within the current NHS, the claim to honour the wishes of the patient is at odds with the desire to micromanage how we treat them. As the QOF juggernaut hurtles blindly onward, shared decision making will be one of the casualties.

Competing interests: None declared

Jonathan D Sleath, General Practitioner

Kingstone Surgery, Hereford, HR2 9HN

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