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Partners in Care: Asking the Right Questions

Research has shown that when a patient is involved and engaged in making their own medical decisions, they are more likely to have positive outcomes from treatments and procedures. We call this “shared decision-making.” Shared decision-making happens when clinicians and patients work together to incorporate the patient’s preferences into medical decisions and tailor those decisions to each individual patient’s needs. In medicine in general, and in cardiology in particular, this is the direction we are moving toward, where treatment decisions are made with a patient, not for a patient.

Starting conversations

In November 2018, the American College of Cardiology and the American Heart Association released updated guidelines on cholesterol management. This document provides physicians with a roadmap for deciding which course of treatment a patient needs to lower their cholesterol. This was the first update in five years, and one of the biggest changes in this new guideline was that each component was written to allow for more personalized care for patients.

The guideline puts more emphasis, for instance, on patients who without question need medication, which allows for a conversation between a doctor and a patient when risk maybe isn’t as high and medication maybe isn’t as necessary. This is one of many important tools available to make sure shared decision-making becomes a part of our medical culture.

Getting prepared

But how can you as a patient make sure you are part of your own care team? While there are many ways to be involved in the decision-making process, starting a dialogue and asking questions should be the first step in creating patient-centered care.

Here are some starting questions for you to kick off the conversation with your doctor:

  1. Is there a decision aid to help me more fully understand the potential benefits and harms of the options for screening or treatment?
  2. What are the benefits and drawbacks to each of my treatment options?
  3. Which option matches with what I value most about my health?
  4. What other things should I consider when trying to make a decision that’s best for me and suits my life?
  5. Is this particular decision aid unbiased? How was it developed? Who developed it?

There is no one approach that works for everyone when it comes to managing health conditions. By asking these questions, you are paving the way to making informed decisions regarding your personal medical health.

C. Michael Valentine, MD, FACC, President, American College of Cardiology, [email protected]

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