Kevin J. Bozic, MD, MBA; Jeffrey Belkora, PhD; Vanessa Chan, MPH; Jiwon Youm, BS, MS; Tianzan Zhou, BS;, John Dupaix, MD; Angela Nava Bye, MA, ATC; Clarence Braddock, III, MD, MPH, FACP; Kate Chenok, MBA; James Huddleston III, MD

1. Shared Medical Decision Making in Patients
with Osteoarthritis of the Hip and Knee
Kevin J. Bozic, MD, MBA1,2, Jeffrey Belkora, PhD2, Vanessa Chan, MPH 1,2, Jiwon Youm, BS, MS3,
Tianzan Zhou, BS5, John Dupaix, MD6, Angela Nava Bye, MA, ATC4, Clarence Braddock, III, MD,
MPH, FACP8, Kate Chenok, MBA7, James Huddleston III, MD4
1University of California, San Francisco, Department of Orthopaedic Surgery
2University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies
3University of California, San Francisco, School of Medicine
4Stanford University, Department of Orthopaedic Surgery
5University of California, San Diego, School of Medicine
6University of Hawaii, Department of Orthopaedic Surgery
7Pacific Business Group on Health
8Stanford University, School of Medicine
WHAT IS SHARED DECISION MAKING (SDM)?
Shared Decision Making (SDM)
In SDM process both physician and •Incorporates patient preferences and values into decision
patient make necessary making
contributions to the dialogue. •Useful for„preference sensitive care‟
• No clear„best‟treatment option
•Goal: improve decision quality, reduce unwarranted
variation
Physician providers expert clinical
Patient contributes personal input
knowledge of conditions,
of their tolerance for risk,
treatment options and associated
preferences for lifestyle, and
risks, benefits + limitations of
guiding values.
evidence.
SHARED DECISION MAKING TOOLS
• Decision aids (DVD/booklets)
• Disease, treatment alternatives
• Communication aids (prompt sheets, health coaches)
• Develop questions (Question listing)
• Questionnaires
• Assess knowledge, health related values, preference, decision status
WHAT ARE THE POTENTIAL BENEFITS OF SHARED DECISION MAKING?
• More informed patients
• More satisfied patients
• Increased efficiency of office visits
• More appropriate utilization of resources
PATIENT REACTIONS TO SHARED DECISION MAKING:
•“Great to refresh memories and helpful for future doctors.”
•“Complete and detailed, very informative”
•“Decision and consultation service was fantastic. Made me feel so well-prepared. This is how medicine should work.”
•“Having the booklet info available online was terrific. This was exactly the material (statistics) I was looking for all over the web, but
having a hard time finding in a consolidated format that made sense.”
•“The consultation with doctor was superb.”
•“Everything was very proactive."