Author Affiliations: Robert Wood Johnson Clinical Scholars Program, University of Michigan School of Medicine, Ann Arbor (Drs Keirns and Goold); Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor (Drs Keirns and Goold); Bioethics Program, University of Michigan, Ann Arbor (Drs Keirns and Goold); VA Health Services Research and Development Center of Excellence and Department of Ambulatory Care, Ann Arbor VA Health System (Dr Keirns); and Center for Medical Humanities, Compassionate Care, and Bioethics, Departments of Preventive Medicine and Department of Medicine, Stony Brook University, Stony Brook, New York (Dr Keirns).
Over the past 20 years or so, there has been a rise of 2 parallel movements, one toward the explicit use of clinical trial data to guide clinical practice (evidence-based medicine) and the other toward patient empowerment through explicit informed consent, shared decision making, and patient-centered care. Both components have been integrated into models of quality clinical care, but sometimes there are conflicts between evidence- and guideline-driven care and patient-centered care.
Keirns CC, Goold SD. Patient-Centered Care and Preference-Sensitive Decision Making. JAMA. 2009;302(16):1805-1806. doi:10.1001/jama.2009.1550