Dr Alan Balch on Improving Shared Decision-Making in Cancer Care

Patients and providers often have very different views of goals and values when it comes to treatment, so healthcare could benefit from figuring out how to systematize the shared decision making experience, Alan Balch, PhD, chief executive officer of the National Patient Advocate Foundation, said at the Community Oncology Alliance's 2016 Community Oncology Conference.

Patients and providers often have very different views of goals and values when it comes to treatment, so healthcare could benefit from figuring out how to systematize the shared decision making experience, Alan Balch, PhD, chief executive officer of the National Patient Advocate Foundation, said at the Community Oncology Alliance's 2016 Community Oncology Conference.

Transcript (slightly modified)

How can patients ensure that their values and goals are heard by providers?

I think part of it starts with one of the things we recognize is that patients often think about those terms—value and goals—differently than providers do. And there's a differential in the patient population itself as to how naturally patients think about or gravitate to those types of ideas when they're thinking about their care and how much time and thought they want to invest in that kind of thinking. A lot of patients are just thinking "how do I get cured? And I want to put my care in the hands of someone who is going to do that."

So I think part of it evolves around helping patients understand what it means and preparing them for those conversations around values and goals and cost and benefits and so patients understand how to talk in that language and how to translate it for themselves so they can talk about the personal ways in which they think about their own values and goals. And there needs to be a common language between providers and patients, because there is a different typically in what patients think about when it comes to values and goals and costs and benefits and how they takle about them and express them as opposed to other stakeholders in the system, including providers.

I think it would be helpful to have some common language and be able to talk about those things in some common frame of reference so that it will make for more mutually beneficial dialogue between providers and patients.

Many providers do it very, very well, and I don't want to suggest that there is always this gap between how patients and providers come at it. There are certainly some great examples of provider across the spectrum from physicians down to nurses and back up the chain that really understand either how to assist their patients and pulling that information out from them or responding and reacting appropriately to the patients as they're trying to express those things.

But I do think we could do a much better job of figuring out how to systematize that whole experience, that whole shared decision making experience and those conversations around values and goals so that they're not so different every single time. Obviously, what is going to matter and what patients want to talk about will differ everytime, but the framework and the process by which that conversation occurs and the preparation that goes in for the patient to have that conversation could be something that could be better systematized.