Twelve myths about shared decision making

• This paper summarizes a keynote address held in the fall of 2013 at the International Conference on Communication in Healthcare. • There are many misconceptions about barriers to shared decision making in practice. • We investigated the evidence relating to the most common of these misconceptions. • We discuss the twelve most prevalent and summarize the state of the evidence. • These misconceptions should not hold back the implementation of shared decision making across the healthcare spectrum. As shared decision makes increasing headway in healthcare policy, it is under more scrutiny. We sought to identify and dispel the most prevalent myths about shared decision making. In 20 years in the shared decision making field one of the author has repeatedly heard mention of the same barriers to scaling up shared decision making across the healthcare spectrum. We conducted a selective literature review relating to shared decision making to further investigate these commonly perceived barriers and to seek evidence supporting their existence or not. Beliefs about barriers to scaling up shared decision making represent a wide range of historical, cultural, financial and scientific concerns. We found little evidence to support twelve of the most common beliefs about barriers to scaling up shared decision making, and indeed found evidence to the contrary. Our selective review of the literature suggests that twelve of the most commonly perceived barriers to scaling up shared decision making across the healthcare spectrum should be termed myths as they can be dispelled by evidence. Our review confirms that the current debate about shared decision making must not deter policy makers and clinicians from pursuing its scaling up across the healthcare continuum.