FAIR Health Consumer Access

Shared Decision Making and Preference-Sensitive Conditions

Do you need to talk to your doctor about treatment options for your health problem? Are you not sure which treatment option is the best choice for you? This article suggests ways to talk to your doctor about three common health problems where there may be no clear, “right” option. They are uterine fibroids, type 2 diabetes and slow-growing prostate cancer. Of note, this article does not provide medical treatment advice.

What’s Shared Decision Making?
To get the best care, it helps if you and your doctor make decisions together. The process is called “shared decision making.” Your doctor shares medical expertise, and you share what you hope for or want out of care. Then, you make a decision together.

Shared decision making is helpful when there’s more than one treatment option. Your doctor can give you a “decision aid,” which is often a flyer, video or online tool that explains different choices, with their risks and benefits. Decision aids also help you think through your own priorities. Then, you and your provider can talk through the options and your questions.

More and more doctors are using a shared decision-making approach for health issues that have no clear, single treatment option. Conditions such as these are called “preference-sensitive conditions.” Treatment options can sometimes range from taking prescription medication to having surgery to, in some instances, a “watch and wait” approach. Some examples of preference-sensitive conditions are uterine fibroids, type 2 diabetes and slow-growing prostate cancer.

Getting the Most Out of Your Doctor Visit. Whether you’re seeing your doctor online or in person, good communication between you and your doctor is key to getting the most out of your visit. For tips on how to maximize your visit and make informed choices about your health, click here.

Uterine Fibroids
Uterine fibroids are tumors that grow in the wall of the uterus (or womb). They’re usually noncancerous. Many women have uterine fibroids at some point. Some may have pain and heavy menstrual bleeding. Others may have no symptoms and not even know they have uterine fibroids.

Treatment options. Treatment for uterine fibroids depends on your symptoms. If you have mild symptoms, your doctor may suggest taking medication such as low-dose birth control pills. If you have severe symptoms, like heavy bleeding or pressure in the pelvis, your doctor may recommend certain procedures like surgery as the best way to treat them.

Questions to ask your doctor. There are several important questions to ask your doctor if you have uterine fibroids. Some key questions include how many fibroids you have, what are their size and where they’re located. It’s a good idea to work with your doctor to determine the best treatment option and understand if there are any problems uterine fibroids may cause.

Type 2 Diabetes
Type 2 diabetes is the most common type of diabetes. It’s more common in adults. The increase in the number of children with obesity also has led to more cases in younger people. If you have type 2 diabetes, your body doesn’t use insulin correctly. This affects the way your body regulates and uses sugar (or glucose).

Treatment options. Some people can control their blood sugar levels with healthy eating and being active. Others may need their doctor to prescribe insulin or other medication to manage it.

Questions to ask your doctor. One key question to ask your doctor is how to control your diet and lifestyle in a healthy way. It’s also important to find out your goals for your blood sugar levels and how often you should check them. If your doctor has prescribed you insulin or other medication, you also may want to find out about any side effects. Be sure to work with your doctor to come up with the best treatment option for you.

Slow-Growing Prostate Cancer
Some doctors describe prostate cancer as “slow growing” if it’s found only in the prostate and is likely to grow only very slowly or not at all.

Treatment options. A common approach to treating slow-growing prostate cancer is to watch and wait. Some men may never need treatment. You and your doctor may keep track of it without treating it. Other treatments may include radiation and surgery.

Questions to ask your doctor. It’s important to ask your doctor questions and to work with him or her to find the best treatment option for you. Some questions include finding out if early detection leads to better outcomes and what symptoms to look out for if you do have any.

Decision Aids
As mentioned, decision aids are tools used in shared decision making to show you different medical treatment choices for your health problem. Thanks to a grant from the New York State Health Foundation, we’ll be featuring decision aids with clinical and cost information for uterine fibroids, type 2 diabetes and slow-growing prostate cancer on our consumer website in spring 2022.