Table I.

Common misperceptions regarding SDM

Misperception	Comment
Face-to-face SDM is always the goal	Where SDM occurs is likely far less important than whether the process itself occurs. Although this has traditionally been achieved with in-office, in-person discussion, use of telehealth tools can extend the definition of the “office” and “in-person.” At home with the family may be superior for some, because it may allow for more individuals affected by the decision beyond the patient to participate
SDM takes too much time	Incorporating SDM should be viewed as an extension of the normal planning for any treatment decision, where patient input should be sought. Some discussions and decisions may be more involved and may require additional visits or conversations. Involving staff and validated SDM aids may be helpful to facilitate this process and can be distributed to the patient before or after a visit, which could save face-to-face time if this is a concern
Most patients prefer not to participate in medical decision making	There is no evidence that this is factual. The degree to which a patient wants to participate in this process is variable, and may depend on the issue at hand, the treatment decision, the patient, and the perception the clinician is receptive to patient input
Few health care decisions are appropriate for SDM	All decisions should have patient input. Where there is a very clear and strongly recommended treatment (eg, treating asthma vs leaving it untreated), there may be less efficacy of SDM tools vs situations in which there is less clarity in which option to choose (eg, which asthma treatment should be chosen)
SDM conflicts with guidelines and quality measures	SDM has been shown to only enhance not deter clinical outcomes, improve engagement, and would involve choices that are derived from guidelines and quality measures as part of the considerations in the treatment decision