There is a growing trend to take a more active role in our own health and well-being. Many of us feel more comfortable questioning decisions that impact our bodies, and we don’t blindly follow the advice of our doctors as we may have done in the past. However, we still need to be aware of ways that healthcare providers can better interact with us to help us make decisions. Shared Decision Making is an important component to the ever-changing face of modern healthcare. On the most basic level, Shared Decision Making is a conversation between a patient and healthcare provider regarding treatment options, goals, and treatment plan. Formally, Shared Decision Making involves five components:
1. At least two participants must be involved
2. Both parties need be active participants in treatment decisions
3. Information sharing is required prior to decision making
4. Both parties must discuss treatment preferences
5. Both parties must agree upon the decision
At Therapeutic Associates Physical Therapy, we hope that our patients already have had a Shared Decision Making conversation with their physicians regarding physical therapy, as well as other possible treatment options for their conditions. If they have, this sets a greater base moving forward for more Shared Decision Making conversations. If they have not, they will be introduced to Shared Decision Making at Therapeutic Associates.
Physical therapy is comprised of several components, and appointments can be shaped in many ways based on patient needs and patient-therapist preferences. The patient and physical therapist come up with a treatment plan together following their discussion. We don’t expect patients to know everything about physical therapy or exact treatments, but that is part of the education process. We realize time, finances, support, and previous experiences all play a part in the decisions we make.
Sticking with a treatment plan is key to its success, and when people get to share in creating that plan, they are more likely to follow through with the process. As a patient, knowing what your goals are, what type of treatments have worked and not worked for you in the past, and knowing how you learn best can assist you in having a successful Shared Decision Making conversation with your healthcare provider.
At any of our locations, we use specific tools to help us gather this information and make Shared Decision Making a driving force in the conversation about your care.
In anticipation of your first appointment, the following tool (see page 16) may be helpful to assist with beginning the Shared Decision Making conversation with your physical therapist. The form is generic and may be helpful to use in discussions with other healthcare providers as well.
More specific to physical therapy is the Patient-Specific Functional Scale. Part of shared decision making in physical therapy is joint goal setting. Physical therapy is focused on increasing function, from more strenuous activities like walking and running to daily tasks like housework or brushing your teeth. To make physical therapy individualized and appropriate for each patient, we like to ask about functional activities that are currently limited due to pain, weakness, or another condition. The Patient-Specific Functional Scale assists in the conversation with your therapist regarding goals, and may include up to 3 things you’re having trouble doing that you would like to work on in physical therapy.
These tools can assist with goal setting and allow us to understand your learning style more efficiently. We want you to be involved in your care while we work as a team to get you back to doing the things you love. Through Shared Decision Making, we believe we can do that more efficiently and collaboratively, leaving you confident and satisfied in the decisions we’ve made together as a team.
There is no expectation that you come in knowing what treatment is best for you. We just ask that you come in willing to share in the process of deciding what is best for you and your body. Our promise and commitment to you is we will listen!
Dierckx, Katreine et al. “Implementation of Shared Decision Making in Physical Therapy: Observed Level of Involvement and Patient Preference” Physical Therapy 93.10 (2013): 1-10.