Guest Post: Healthcare Choices, Patient Voices

A critically important goal of healthcare reform is to deliver patient-centric care.  However, in today’s busy practice of medicine, patients are too often asked to decide on care without fully understanding their options and without the opportunity to think about their preferences.  We make few decisions as important or personal as those affecting our health, yet too often our voice as a patient is not heard.

Healthcare decisions, particularly those regarding care for which there are multiple evidence-based options, (preference sensitive) are common.  82% of adults over the age of 40 have made a decision about a surgery, test, or new medication in the past two years.[i]  Too often physicians lack the training, resources, or time to educate patients on the risks and benefits of their various care options. Doctors do even less well with exploring patients’ personal preferences.  Because patients don’t know what they don’t know, it’s simply not possible to obtain truly informed consent from a patient who is not informed.  Risks and benefit discussions aren’t really meaningful without a full explanation of options and a full exploration of personal preferences.

A Shared Decision Making approach to care educates patients about any and all medically sound treatment options and helps them sort through the confusing clutter of medical terms and acronyms.  Patients are informed on the risks, benefits, trade-offs, and side effects of each viable choice. This approach puts the patient at the center of the decision, ensuring that the selection is not only clinically appropriate, but also the right course for them.   Thus prepared, patients can then have a better quality discussion about their treatment options with their physicians, which is the goal of Shared Decision Making.

As we continue to debate ways to improve quality and reduce costs, Shared Decision Making emerges as one such way.  Patients who go through a Shared Decision Making process tend to choose less invasive procedures[ii], which in turn leads to better outcomes and reduced spend. The patients are happier too, reporting a better care experience and improved doctor-patient communication.[iii]  This approach to care is both effective and practical. It has been successfully adopted in busy medical practices across the country resulting in more loyal patients and more satisfied clinicians.

Healthcare choices are hard. Knowing you even have a choice is paramount. Shared Decision Making will draw out patient voices where they so critically need to be heard.

Dr. Peter Goldbach brings more than 30 years of experience to Health Dialog’s management team, including 15 years of experience in medical administration and 17 years maintaining a primary care and pulmonary disease practice. Prior to joining Health Dialog, Dr. Goldbach served as President and Chief Executive Officer of Med-Vantage Inc., a healthcare informatics and engagement company. Before that, Dr. Goldbach was Medical Director for Blue Cross Blue Shield of Massachusetts, where he provided medical direction for the company’s “Pay for Performance” and eHealth programs. In other previous roles, Dr. Goldbach has held CEO, trustee, and medical staff president positions with two Boston-area community hospitals.

Dr. Goldbach received an undergraduate and master’s degree from UCLA and his medical degree from SUNY Downstate Medical Center College of Medicine. He completed his Internal Medicine internship and residency at George Washington University Hospital, and his Pulmonary Disease fellowship at Cedars-Sinai Medical Center / UCLA School of Medicine.

[i] Zikmund-Fisher., et al. The DECISIONS Study. Medical Decision Making. Sep-Oct 2010.

[ii] Decision Aids for People Facing Health Treatment or Screening Decisions. Cochrane Database of Systematic Reviews. 2011 October 5;(10).

[iii] Ibid.


CCA invites guest bloggers to post on Voice on Population Health Blog as a benefit for our members and the industry and to allow for exchange of ideas and information regarding population health.

The views, opinions and positions expressed within these guest posts are those of the author alone and/or of the company the author represents and do not represent those of the Care Continuum Alliance (CCA), its members, or the industry as a whole. CCA is not responsible for the accuracy, completeness and validity of any statements made within this guest post article. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author(s) and any liability with regards to infringement of intellectual property rights remains with them.


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