Find out what is replacing ‘doctor knows best’, says Rachel Hooke

It sounds like common sense and good practice that patients should make decisions about their own management along with their clinicians.

The traditional paternalistic approach of “doctor knows best” is no longer appropriate in the modern age. However, it is not always that easy to change.

This book is a comprehensive critique of research carried out about decision making that is shared between patient and clinician: a laudable aim, but the analysis shows that it is not straightforward.

There are different methods, different decisions that can be made and different types of patient groups.

There is a very international perspective to the book, with contributing authors from around the world. Concepts are introduced that are, potentially, alien to a British readership, such as decision coaches, patient competencies and information therapy.

Having said that, the NHS Institute for Innovation and Improvement is working on shared decision making. The proposed ideas could, eventually, become mainstream in the UK.

This is a large book with small print - it is not advisable to try to read Shared Decision-Making all in one go.

However, the chapters are short, making it digestible in chunks. Some sections are easier to understand than others and some inconsistencies and inaccuracies of spelling and punctuation detract from the book’s overall quality.

Dr Rachel Hooke is a project manager in Leicester.


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