Can We Choose Wisely?

Dr Ramai Santhirapala is an Honorary Consultant in Anaesthesia and Perioperative Medicine at Royal Surrey County Hospital and a Clinical Advisor at the Academy of Medical Royal Colleges. In the latter role she advises on the international programme ‘Choosing Wisely’, which aims to improve conversations between healthcare providers and patients. Dr Santhirapala’s specialist interests are shared decision making and end of life care, believing patients should lie at the heart of healthcare decisions. She has published in the British Journal of Anaesthesia and Perioperative Medicine and is undertaking research into educational needs for physicians to practice shared decision making. She tweets at @ramai23

Shared decision making (SDM) is increasingly synonymous with healthcare, moving away from paternalism towards a balanced approach to decision making involving both patients and clinicians. What exactly is SDM? That is the ubiquitous question to which there is currently no universally agreed answer. The King’s Fund intimates a definition pointing out SDM is a process during which patients and physicians use evidence based information to support the deliberation process based on patients’ values, beliefs and preferences. This highlights that a physician is still expected to bring clinical expertise, whilst a patient brings expertise on what matters to them.