What's the Role of Time in Shared Decision Making?

Abstract

Shared decision making (SDM) is a desirable process and outcome of patient-clinician relationships. Ideally, patients and clinicians have sufficient time to engage in SDM. In reality, time is often insufficient. This article explores time as a barrier to SDM, alternative ways clinicians can think about time, and steps they can take to have fulfilling SDM interactions despite time constraints. Although discussions of time typically focus on time quantity, redirecting attention to the ethical significance of time in establishing patient-clinician relationships suggests the importance of also considering time quality. Time as a Barrier Shared decision making (SDM)-the process by which clinicians and patients work together to make health care decisions that align with patients' goals, preferences, and values-is an ideal outcome of patient-clinician relationships. 1 Yet multiple potential barriers obstruct SDM in real-life clinical practice. Chief among these is time, particularly the amount and quality of face-to-face time clinicians and patients spend together. Studies have shown that both patients and clinicians view time constraints as a frequent and substantial barrier to SDM.