Original ArticlesA Framework for Encouraging Patient Engagement in Medical Decision MakingHolzmueller, Christine G. BLA*; Wu, Albert W. MD, MPH†§; Pronovost, Peter J. MD, PhD*‡§Author Information From the *Department of Anesthesiology and Critical Care Medicine, †Department of Medicine, ‡Department of Surgery, Johns Hopkins University School of Medicine; and §Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Correspondence: Peter J. Pronovost, MD, PhD, 1909 Thames Street, 2nd floor, Baltimore, MD 21231 (e-mail: email@example.com). Conflicts of Interest: Ms. Holzmueller received honorarium from MCIC Vermont for speaking about methods to organize content and write a quality improvement or patient safety research paper. Dr. Wu reports financial support from MAPI and Genentech for board membership; consultancy fees from Pfizer, Merck, and GSK; honoraria for speaking at various health-care organizations; royalties from Lippincott and The Joint Commission; and grant support to Johns Hopkins from the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, and National Institutes of Health. Dr. Pronovost reports consultancy fees from the Association for Professionals in Infection Control and Epidemiology, Inc.; grant support from Agency for Healthcare Research and Quality, National Institutes of Health, Robert Wood Johnson Foundation, and The Commonwealth Fund; honoraria from various hospitals and the Leigh Bureau (Somerville, NJ); and royalties from his book, Safe Patients Smart Hospitals. Journal of Patient Safety: December 2012 - Volume 8 - Issue 4 - p 161-164 doi: 10.1097/PTS.0b013e318267c56e Buy Metrics Abstract Patients have a right to make decisions about their medical care because they have the most at stake. Although current social forces and policies press for greater patient participation, there is little guidance on how physicians can comply. This paper describes the current culture influencing the physician-patient relationship, offers a practical framework and strategies to physicians to engage patients in medical decision making, and discusses the implications for patient safety. We describe several barriers that make patient involvement difficult to practice, such as differences between models that define the roles of both parties in the relationship. Arguably, patients should make all medical care decisions, but there are situations when this is not feasible. Nonetheless, there is a greater imperative for patient decision making if there are multiple treatment options; if the alternatives differ relative to clinical, quality-of-life, or financial outcomes; or if there are different clinical risks and benefits. We offer 3 strategies to encourage patients to make medical decisions and suggest implications for the field of patient safety. © 2012 Lippincott Williams & Wilkins, Inc.