Intended for healthcare professionals

Observations Reality Check

The future of medicine lies in truly shared decision making

BMJ 2013; 346 doi: (Published 14 May 2013) Cite this as: BMJ 2013;346:f2789
  1. Ray Moynihan, author, journalist, and senior research fellow
  1. 1Bond University, Australia
  1. RayMoynihan{at}

Could the public play a greater role in helping reform the healing profession?

One of the welcome shifts under way in medicine is the move towards “shared decision making,” where hubris and hierarchy give way to humility and equality.1 Part of a wider reshaping of the roles and responsibilities of patients and professionals,2 the shift is challenging the long held belief that doctors know best. Rather than experts who persuade, in the new model the professionals support people in making more informed decisions about their health. But what if we take this notion of a meeting of equals seriously? Could people help professionals to make more informed decisions? Not by offering tips to the surgeon from the operating table but rather by citizens playing a more active role in some of the big and pressing debates about the future health of medicine.

As more and more voices inside the medical establishment identify the problem of too much medicine (, a broader conversation with a wider …

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