The authors note that progress in embedding shared decision making into routine care has been slow, despite the recommendation of the Institute of Medicine about SDM in the seminal publication "Crossing the Quality Chasm" back in 2001.
The New England Journal of Medicine editorial, and you don’t get more influential than that , points out that studies in the USA also illustrate the potential for wider adoption of shared decision-making to reduce costs. Consistently, as many as 20% of patients who participate in shared decision making choose less invasive surgically options and more conservative treatment, than patients that do not use decision aids.
The authors suggest that providers who do not document shared decision making processes for preference sensitive health care choices about procedures, should face a 10% reduction in payments for those procedures with reductions in payment gradually increase to 20% over 10 years. It will be interesting to read the letters page of the NEJM next week!!