WTF is Shared Decision-Making?

A guide for adolescents

Are you between the ages of 14-18? If not, stop

reading please. This guide is designed by a
teenager, for teenagers.

Before we begin our journey into SDM, remember

that your loved ones care about you. Sharing is
caring, after all. And however difficult the situation
may become, they wish the best for you, even if
you disagree in the way they express their care.

Now, lets get started!

Step One: Know The Triangles

No, not that triangle. Although there is a

triangle, I can assure you, the illuminati will
not be involved.

In fact, we actually have three triangles!

These triangles consist of three people, the
doctor, the parent and the child. Yes, I know
you are not a child, but many medical
definitions of child include individuals 18
and under.

Why is this triangle important? Well because this is who will be involved in shared
decision-making. Notice that one triangle is not bigger than the others. That
means that you have an equal say in the shared decision-making process! This
medical model differs from the traditional, or paternalistic model, which looks like
a two big-ass triangles squashing a smaller one. As you can already guess, the
bigger triangles represent the Doctor and the Parent. But fear not! In shared
decision making you can let your voice be heard.

Step Two: Conversation Starters

Unfortunately, asking Yo medicine man,

can I finesse some drugs? is a not a
good way to gain a doctors attention.
However, some good conversation
starters include:
"I want to go over all the options to find
the one that best works for me."
I would like some more details about
my options.
"Now that we have identified the
problem, it's time for us to think about
what to do next."
Doctors are people too! It might seem intimidating to talk to a doctor, but
communication is key (and most doctors are very willing to talk). In SDM, medical
decisions are not only in the doctors (hopefully steady) hands, but also in your
control. At any stage of the medical treatment, it is OK to ask the medical provider
to explain what they might be doing.

It is also important to include family members, and loved ones in the decisionmaking process. Simply saying I would like your input is a great way to
encourage loved ones to feel like they are also part of the process. This will help
adults understand what you are going through.

Step Three: Too Many Choices

Have you ever tried to buy peanut butter at the store? There are literally a hundred
different peanut butters to choose from. Do I want crunchy or smooth? Fat-free? Saltfree? The weird foreign stuff thats twice as expensive? Too many choices can make it
difficult to make a decision. Similarly, the vast range of medical options can seem
difficult to navigate.
When considering treatment options, it is important to understand each option in
detail. Many treatments involve tradeoffs. For example, "Medicine X is has more side
effects than the one you are currently taking, but you will only have to take it once a
day." In these situations, ask the medical provider to explain each option in plain-old
English.

Google is actually a very useful tool to identify potential medical treatment options.
Although I cant say Random_Dude123s Blog on Medicine is always inaccurate, you
can search more than one website to weed out inaccuracies.
After you Google, tell your medical provider what you learned! Your doctor might also
learn something, for example, a new experimental drug.

Step Four: Decisions (I wanna eat the whole cake)

Congratulations, this step is the most
exciting part. Its time to make your
medical decision.
Here are the 3 Rs you should keep in
mind:
1. Reversibility: Is this decision easily
reversed? Surgery, for example,
may be an irreversible process.
2. Risk: What risks am I taking when I
make this decision?
3. Responsibility: What do I need to do
to make sure the treatment goes
properly? This might include
instructions for taking medication
on time.

This is your medical decision! That means you can take all the time you need,
well unless you have a bone sticking out of your arm. If you do have a bone
sticking out, make sure to get that treated ASAP. However, if you are not in an
emergency, make sure that you are confident in your decision, and understand
the procedure in detail. It may be useful to ask yourself: Are there other people
that
you Just
wantkidding.
to talk to
in order
tomade
help you
this decision?
Youre all
done!
After
youve
yourmake
decision,
be sure to notice
any uncomfortable or unfamiliar symptoms that may result from your treatment.
After arriving
a decision,
is important
to verify
theeffects
timingof
and steps
Many symptoms
thatupon
may seem
scaryitare
perfectly normal
side
for treatment.
Then your
schedule
a followup
appointment if necessary.
medicalneeded
procedure.
However, keep
doctor
up to date.

Step Five: Sit Back and Relax

5

For chronic diseases or

treatment requiring patient
participation, it is crucial for you
to be involved 100%.
For medication, a weekly pill
organizer can be useful in
keeping track of treatment. For
others, simply keeping info in a
calendar app is enough. Finding
a system that works for you is
the most important.
Best wishes, and I hope you have a fast recovery!

Works Referenced
Levinson W., Kao A., Kuby A., et al. Not all patients want to participate in decision making. A

national study of public preferences. J Gen Intern Med 2005 Jun;20(6):531-5. PMID:
15987329.
Little P., Everitt H., Williamson I., et al. Preferences of patients for patient centred approach to
consultation in primary care: observational study. BMJ 2001. 322(7284):468-72. PMID:
11222423.
Makoul G., Clayman M.L. An integrative model of shared decision making in medical
encounters. Patient Educ Couns 2006 Mar;60(3):301-12. PMID: 16051459.
National Research Council. Crossing the quality chasm: a new health system for the 21st century.
Washington, DC: National Academies Press, 2001.