Author Affiliations: Division of General Internal Medicine and Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco (Dr Lin); Palo Alto Medical Foundation (Dr Trujillo) and Research Institute (Dr Frosch), Palo Alto, California; and Division of General Internal Medicine and Health Services Research, University of California, Los Angeles (Dr Frosch).
A 60-year-old woman presented to her physician for an annual physical examination. As part of the examination, she and her physician discussed colorectal cancer screening, which her physician had discussed with her at her last yearly physical. The decision at that time had been for colonoscopy, and the patient was referred to the gastroenterologist. Since the patient never followed through with the colonoscopy, the topic was broached again. As part of a quality improvement initiative designed to promote shared decision-making, the patient was given a decision support intervention (DESI) to review the options (fecal occult blood testing [FOBT], flexible sigmoidoscopy, or colonoscopy, described in a booklet and DVD) and was told to let her physician know about her decision.
Lin GA, Trujillo L, Frosch DL. Consequences of Not Respecting Patient Preferences for Cancer ScreeningOpportunity Lost. Arch Intern Med. 2012;172(5):393-394. doi:10.1001/archinternmed.2012.58