Shared decision making

Deciding to have major surgery can be difficult. This is especially true if your surgery is ‘high risk’ due to other health issues you may have

Cancer Education

We understand your decisions about surgery depend on what is important to you. Shared Decision Making is a process that helps support you. It helps you to make decisions together with your care team about your surgery. These will be decisions that align with your goals for the future.  

This short film describes how Shared Decision Making could help you to plan for surgery. You may find it helpful to watch this film a few times or with your friends and family. For more information, please ask your care team or see the information below the film. 

We have put together often asked questions and answers about Shared Decision Making. This will help you understand how Shared Decision Making might aid your plan for surgery, 

What Shared Decision Making is 

Shared Decision Making helps patients. It enables them to be more involved in decisions made about their health care. 

It involves a two-way sharing of information.  

  1. Your healthcare team will share information with you. This information will include what treatment options are right for your specific situation. The options discussed will vary for each patient. They may include surgery, radiotherapy, or chemotherapy. They can also include treatments aimed at the relief of symptoms. The best treatment for you may involve a combination of these therapies
  2. It also involves you sharing your thoughts with your treating team. This includes factors important to you when making decisions about treatment options
  3. Your healthcare team will then recommend a treatment choice. This choice will be the one most likely to help you achieve your goals. They will base it on the preferences you have expressed

This process often works in partnership with our other programs. These programs improve your physical, emotional, nutritional and general health before your treatment. 

These include:  

How Shared Decision Making could help you to prepare for surgery 

Our shared decision-making process is usually made up of three steps:  

1. A primary Shared Decision Making Clinic appointment 

At this first meeting, we will review your medical journey up to that point with you. We will also explore the range of treatment options available. These options will be for your specific situation. This could include surgery as well as other treatment options. Such options might include chemotherapy, radiotherapy or therapies that focus on symptom control. We would also like to learn more about you. This may include discussing what your life currently looks like. We will also find out what you hope to achieve out of treatment and what is important to you. Understanding you in this way helps us to make more individualised treatment recommendations. 

2. A multidisciplinary team meeting 

This is a meeting for our different healthcare workers involved in your care. This can include surgeons, anaesthetic doctors, physiotherapists and intensive care doctors. It can also include specialist doctors like cardiologists or kidney specialists. We will review your case in this meeting. We will also discuss the potential risks and benefits of all possible treatments. We will discuss which treatment aligns with your treatment goals. These treatments will reflect what is important to you. This discussion is confidential. It forms the basis of any recommendations that the team makes. You will not be present at this meeting. We will share a verbal summary of this meeting's recommendations with you though. We will provide this summary at the follow-up Shared Decision Making clinic appointment. 

3. A secondary Shared Decision Making Clinic appointment 

This is the second appointment that we have with you. We will summarise the multidisciplinary meeting's discussion points and recommendations. We will then explore your thoughts about these suggestions. We will also give you the chance to clarify any details or ask any questions. You do not have to make any decisions about treatment at this point.   

The team will make a recommendation to you based on your expressed values and goals. The choice of treatment is a decision you will make together with your surgeon though. 

What can you expect from a Clinic appointment? 

We will book you in for a Shared Decision Making Clinic appointment. At this appointment you will have a conversation with one or two senior doctors. These will be senior anaesthetic doctors (Anaesthetists) in most circumstances. Anaesthetists are often well placed to have these conversations. This is because they lead our processes to improve fitness and health before surgery. They also work with surgeons. As a result, they understanding well the potential risks and benefits of surgery. 

This first appointment usually takes about an hour. Sometimes, it happens on the same day as a: 

Shared Decision Making clinic appointments may occur in person or via phone/telehealth. This will depend on your location and circumstances.   

Who you should bring to your Clinic appointment 

You don’t have to bring anyone with you to this appointment. Many people find it helpful to bring along a family member or close friend though. 

You may have someone who you would trust to make medical decisions for you if you are not able to. We sometimes refer to this person as a Medical Treatment Decision Maker. It would be important to bring this person to your appointment. 

Find out more about your Shared Decision Making Clinic appointment. 

What you should bring to your Shared Decision Making Clinic appointment 

You may have Advance Care Planning documentation or Medical Power of Attorney documentation. If so, please bring these along to your appointment. 

An Advance Care Plan is a collection of documents. They are for people should they be unable to make decisions. They ensure we deliver medical treatment consistent with your preferences and values. We sometimes call an Advance Care Plan an Advance Directive or a Living Will. At some point you may be unable to communicate with us yourself. If so, this Advance Care Plan can help your family, friends, and doctors. It lets them make medical decisions on your behalf. 

Find out more about an Advance Care Plan. 

What you can do to prepare for your Shared Decision Making Clinic appointment 

Please watch the film at the top of this page. You may find it helpful to watch it a few times or together with family and friends.  

It may also be helpful for you to have a think about some of the following information:   

  • How your illness has affected your current quality of life  
  • What you would consider a ‘good’ outcome of treatment 
  • What you would consider an ‘unacceptable’ outcome of treatment 
  • Any hopes or goals you have for the immediate or distant future  
  • What a ‘good’ quality of life looks like for you  

Where you can go for some more information about Shared Decision Making 

More information about Shared Decision Making for surgery is available. Please discuss this with your surgeon, anaesthetists, or perioperative nurse coordinator.  

You can raise any of the topics covered on this webpage with your healthcare team. They will also be able to refer you to someone you could speak to in person. Your anaesthetist may also raise some of these issues with you. 

Related  links

Cancer Council