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How should doctors share decisions with their patients?

The New Yorker, July 8, 2013

According to the Affordable Care Act, one answer is something called "shared decision-making," or S.D.M. It's an approach to medical care in which patients are encouraged to make decisions with their doctors. Though S.D.M. has captured the attention of policy leaders, investors, and researchers over the years—leading to the creation and testing of support tools, known as "decision aids"—it is rarely used in clinical practice. The A.C.A. aims to change that; it requires Accountable Care Organizations to integrate S.D.M. into the daily rhythms of patient care. Patient-satisfaction surveys, which are being used to partially determine reimbursement, will ask patients whether or not their care honored the principles of S.D.M.