To the Editor We read with interest the study carried out by Fowler and colleagues,1 describing patients’ involvement in the decision-making process for common medical conditions encountered in primary care. Remarkably, decisions about prescribing medication to lower cardiovascular risk (for hypertension and lipid control) were reported to be mostly physician driven, with discussions being oriented toward the pros of medication. In regard to decisions about prostate and breast cancer screening tests, there was very little discussion about harms vs benefits of routine prostate-specific antigen screening and mammography, while patients’ age was not taken into consideration. Another unexpected finding was that decisions made in primary care settings appeared to be more paternalistic compared with those in surgical settings.
Symvoulakis EK, Anyfantakis D, Markaki A. Patient-Centered Decisions in Primary CareFrom Necessity To Realism. JAMA Intern Med. 2014;174(3):474. doi:10.1001/jamainternmed.2013.12878