Intended for healthcare professionals

Feature Shared Decision Making

Welcome to the century of the patient

BMJ 2011; 342 doi: (Published 06 April 2011) Cite this as: BMJ 2011;342:d2057
  1. Anne Gulland, freelance journalist
  1. 1 London, UK
  1. annecgulland{at}

To mark the signing of the Salzburg statement on shared decision making, the BMJ brought together 14 doctors, patients, academics, and policy makers to discuss how to involve patients in decisions about their health. Anne Gulland reports

The 21st century should become the century of the patient, according to Gerd Gigerenzer, director of the Centre for Adaptive Behaviour and Cognition in Berlin and one of the participants in a BMJ discussion group last month. But how do we make it so? What new skills and what shifts in attitudes do both patients and health professionals need? The Salzburg statement on shared decision making lists various actions in its call for patients and clinicians to work together to be coproducers of health (BMJ 2011;342:d1745, doi: 10.1136/bmj.d1745). The statement, which arose from a meeting of the Salzburg Global Seminar last December, provided the springboard for the BMJ round table discussion, chaired by BMJ editor in chief, Fiona Godlee. The discussion broke into three sections: the first looked at the history of shared decision making and the current situation both in the UK and elsewhere; the second looked at a vision of the future and the barriers to getting there; and the third considered the information needs of patients and doctors.

Current situation

Angela Coulter, director of global initiatives at the Foundation for Informed Medical Decision Making, kicked off the discussion by explaining the need for the Salzburg statement. Although there was much research and policy interest in shared decision making, most patients report that they are not involved or informed in decisions about their care as much as they would like.

“A lot of evidence suggests that clinicians are very good at explaining the benefits and not very good at explaining harms and uncertainties,” she said.

In the US shared decision making is on …

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