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To the Editor: I am concerned with the conclusion of the Commentary by Dr McNutt on shared medical decision making.¹ I cannot understand why any physician would want to "maximize decisional conflict" in a patient already stressed with an illness and decrease the chance of a positive patient outcome. It appears that the described process of decision making is more for the benefit of the physician than the patient.

My patients express 2 common desires: to be treated with dignity and to have a caring relationship with their physician. The former includes honestly educating patients about prescribed treatments, including possible negative outcomes. However, the latter sometimes demands that physicians extend themselves as they attempt to educate patients, even when they know that words shape concepts. Doing so without prejudice can be difficult, but not doing so is to abdicate an important responsibility. Simply tossing out numbers and sitting back with . . . [Full Text of this Article]

Jeffrey R. Waggoner, MD
jrwbsbl@aol.com
Denver, Colo