Shared decision-making is a crucial aspect of patient-centered care, yet recent medical journal articles highlight the challenges it faces. Despite these obstacles, artificial intelligence (AI) may hold the key to revitalizing this essential doctor-patient interaction.
A Perspective in the Journal of General Internal Medicine titled “Saving Shared Decision-Making” acknowledges that shared decision-making is at a crossroads. While efforts to advance the science of implementation are underway, there is still work to be done to ensure that patients are active participants in their healthcare decisions.
The concept of shared decision-making dates back to a report by a presidential commission on ethics in medicine in 1982. The report emphasized the importance of doctors respecting and enhancing their patients’ autonomy. However, decades later, many physicians still struggle to truly involve patients in the decision-making process.
In the realm of cancer care, shared decision-making is especially critical. A review in the journal Psycho-Oncology found that some oncologists struggle with relinquishing decision-making authority, hindering patient involvement in the process. This reluctance can leave patients feeling unheard or unable to voice their preferences.
Even among the next generation of doctors, there are challenges to embracing shared decision-making. A JAMA Perspective titled “When Patients Arrive With Answers” revealed that some medical students exhibit dismissiveness towards patients who come in with treatment recommendations from sources like AI. This resistance to patient input reflects a lingering belief that doctors know best.
Despite these obstacles, AI may offer a solution to the persistent issues surrounding shared decision-making. AI has the potential to provide detailed, personalized information that can prompt a reevaluation of physician professional identity. As AI continues to revolutionize healthcare, it will compel healthcare leaders and providers to adapt to the democratization of medical knowledge.
Already, startups are offering platforms that empower cancer patients to compare treatment plans with clinical guidelines and access personalized AI tools. Real-world evidence in cancer care is also becoming more accessible to patients, reshaping the landscape of healthcare decision-making. Platforms like PatientsUseAI Substack are helping patients navigate these new tools and become active participants in their care.
The future of shared decision-making lies in how it evolves to incorporate AI and new technologies. Dr. Sundar, a family physician, advocates for “relational humility” in which doctors view AI-informed visits as opportunities for deeper dialogue rather than threats to their authority. By embracing AI and meeting patients with recognition rather than resistance, clinicians can foster a more collaborative approach to healthcare decision-making.
