Characteristics of General Physicians who Practice Shared Decision Making: A Mail Survey of All Clinics in 12 Municipalities in Tokyo

Abstract

Introduction: Patient-centric treatment is important in primary care, and one of the characteristics of this type of care is shared decision making (SDM) on treatment options between the patient and the doctor. However, no study has examined the circumstances of SDM practice in primary care in Japan. In this study, we investigated the proportion of doctors who practice SDM and examined their characteristics.
Methods: In 2014, we sent a postal survey to one doctor in each of the internal medicine clinics in 10 wards and 2 cities within the Tokyo Metropolitan Area. We evaluated the decision-making methods for treatment using a five-point scale (paternalism, close to paternalism, informed consent, SDM, informed decision making), and evaluated the doctors'background and patient interviews.
Results: Informed consent was the most frequently used decision-making method for treatment (40.8 %), and 14.6% of the doctors opted for SDM. Most of these doctors were in their 50s, and had spent the longest period of their working life in clinics. These doctors also had a tendency to select items that encouraged spontaneous remarks of the patients.
Conclusion: The findings of the present study suggest that the practice of SDM, which is an important factor in patient-centric medicine in primary care, is not very prevalent at present.