Public health is in a bind. The goal of the discipline is to protect and improve the public’s overall health so that populations remain as healthy as possible. Public health considers decisions from a...

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Proceedings of the National Academy of Sciences (PNAS), a peer reviewed journal of the National Academy of Sciences (NAS) - an authoritative source of high-impact, original research that broadly spans...

Importance Shared decision-making is a widely promoted approach, yet clinicians, typically supportive in principle, find it difficult to implement because of concerns and barriers they commonly encounter in practice. Objective To generate a primer that describes shared decision-making from the perspective of clinicians. Methods We collaborated with clinicians, patient representatives, and health service researchers. We invited members of the International Society of Shared Decision Making to co-produce a primer for clinicians using a series of jointly edited online documents. We shared drafts with other clinicians and patients. Finally, we integrated the contributions until we had arrived at a consensus. Findings Twenty-five people from 13 countries contributed; 9 had medical qualifications, 4 had nursing qualifications, and 12 others had a range of backgrounds. A total of 30 patients and clinicians provided further comments. The description differs from previous versions because it addresses the barriers that clinicians frequently mention. It describes how to overcome common challenges by emphasizing the importance of a clear invitation at initiation; it suggests how to manage patients’ resistance to shouldering decisional responsibility; reinforces the need to allow time for deliberation, especially with other stakeholders; and reassures clinicians that consensus, albeit welcome, need not be the goal of shared decision-making. Conclusions and Relevance This primer portrays a reflective clinician who is aware of power asymmetry, patient vulnerability, risk communication, health literacy, agenda setting, and goal clarification. It envisages a clinician who is curious about personal perspectives and who can offer collaborative, iterative, and deliberative steps.

To explore the ability of artificial intelligence to produce comparison tables to facilitate shared decision-making.An expert human-generated comparis…

The 2026 International Shared Decision Making Conference will be held at Dartmouth College from July 7-10, 2026

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Government officials are pursuing multiple plans to reduce healthcare spending while making America healthier. Meanwhile, countless clinicians are already getting the job done—and being punished

Government officials are pursuing multiple plans to reduce healthcare spending while making America healthier. Meanwhile, countless clinicians are already getting the job done—and being punished

UNLEASHED: Redesigning Health Care · Episode

Despite recognition of the importance of measuring the quality of palliative care, there are significant gaps in information about how to do so in real-world settings, particularly for patient-reporte...

The first months of the second Trump administration have, as predicted, been a matter of ungoverning. In the name of efficiency and budget reduction, but