The short answer
When a healthcare choice has tradeoffs, tell your clinician three things in plain words: the outcome that matters most to you, the risk or side effect that worries you most, and the practical limits in your life, like time, money, or caregiving duties. This is what the Agency for Healthcare Research and Quality (AHRQ) calls shared decision-making — combining medical evidence with your personal values to reach a choice that fits you.
Why values need to be said, not assumed
A clinician can explain the medical facts about an option, but only you know how those facts land in your daily life. Two people with the same test result can reasonably choose different paths because one is trying to stay alert for a demanding job and the other is trying to avoid a long recovery while caring for a parent. AHRQ’s SHARE Approach frames shared decision-making as a dialogue that includes exploring benefits, harms, and risks alongside a direct conversation about what matters most to the patient. Without that conversation, a clinician is left guessing.
Build your statement with an evidence ladder
An evidence ladder sorts what you know from what you feel, so your explanation stays clear instead of turning into a long story. Work through it in order and write a short phrase at each step.
- Step 1: Name the decision. State the choice in one sentence. Example: “I am deciding whether to start this medication or continue monitoring.”
- Step 2: List the facts you have been given. Write down the options and any numbers, timelines, or test results already shared with you.
- Step 3: Identify the outcome you care about most. This is the value itself — staying mobile, avoiding time away from work, protecting a caregiving routine, or minimizing daily symptoms.
- Step 4: Name the tradeoff you are least willing to accept. Every option gives up something to gain something else. Say plainly which loss concerns you most.
- Step 5: State your practical limits. Cost, travel distance, insurance rules, or home support can shape which option is realistic, separate from which is medically preferred.
Combine the five phrases into one short statement: “I understand the two options and their risks. What matters most to me is staying steady enough to keep working, and I’m most concerned about the recovery time. Cost is also a real limit for me.”
If the options are medically close, your values should decide
If your clinician tells you two options are roughly equal from a medical standpoint, then the deciding factor should shift to your evidence-ladder answers, not to guesswork about which option “sounds more serious.” Say that directly: “If these are medically close, here’s what should tip it for me.”
Translate a priority into discussion language
| Priority you’re protecting | Phrase to use with your clinician |
|---|---|
| Staying alert for work | “I need to avoid an option that leaves me foggy or fatigued during the day.” |
| Caregiving for a family member | “I can’t be out of commission for an extended recovery right now.” |
| Limiting out-of-pocket cost | “Cost is a real constraint — are there lower-cost options that are still reasonable?” |
| Avoiding a specific side effect | “This particular side effect would be very hard for me to manage. How likely is it?” |
Known versus unknown: sort the conversation before it happens
Confusing what is medically settled with what is genuinely uncertain is a common reason a shared-decision conversation stalls. Before your visit, sort what you’ve heard into two columns.
- What seems to be known: the named options, the general benefit each is meant to provide, and any timeline already given.
- What is still unclear: how the evidence applies to someone with your specific history, how large the benefit or risk is in real numbers, what happens if you delay, and what your own values point to when the options are close.
Bring the “unclear” column in as direct questions. AHRQ’s guidance notes that a balanced conversation lays out the limits of what’s known, not just the benefits, so the decision reflects real uncertainty instead of false confidence.
Practical next-step checklist
- Write your one-sentence decision statement before your appointment.
- Fill in the remaining four evidence-ladder steps in short phrases, not paragraphs.
- Bring your “unclear” column as a list of direct questions.
- Say your value statement early in the visit, not at the end.
- Ask the clinician to reflect your priority back to you, to confirm it was understood correctly.
- If the visit ends without an answer to your biggest uncertainty, ask when and how you’ll get that answer before deciding.
When this approach is not enough on its own
If a choice feels urgent or you’re worried about immediate safety, contact your treating clinician or local emergency services rather than working through this preparation process first. This page is meant to help you prepare for a planned, non-urgent conversation about a healthcare decision with real tradeoffs — not to replace medical advice, delay urgent care, or resolve legal or insurance questions.
Where this fits with the rest of the site
This page focuses narrowly on putting your values and practical limits into words. Before the conversation, gather the facts with the one-page health story guide. For a broader walkthrough of comparing options and closing the conversation with a clear plan, see Take Part in Care Decisions. If you’re new to this publication and want its scope and boundaries first, visit Start Here.
Common questions
What if I don’t know what matters most to me yet?
That’s common, especially with a new diagnosis. Say so directly: “I haven’t fully worked out my priorities yet — can we talk through what this decision could mean for my daily life?” Naming the uncertainty is itself useful information for your clinician.
What if my clinician doesn’t ask about my values?
Bring it up yourself, early in the visit, using one of the phrases in this guide. AHRQ’s SHARE Approach describes this conversation as a shared responsibility, not something only the clinician initiates.
Can a support person state my values for me?
A support person can help you remember or organize your priorities, but the statement works best coming from you directly, since it reflects your own experience and daily life.
Sources and limits of this guide
This page draws on AHRQ’s SHARE Approach, a shared decision-making framework describing the goal of exploring benefits, harms, and risks of options alongside what matters most to the patient, and on AHRQ’s overview of shared decision-making research, which defines shared decision-making as a collaborative process informed by evidence, clinical experience, and the patient’s own values, goals, preferences, and circumstances. This page does not diagnose, recommend a specific option, calculate personal risk, or replace advice from your care team.
Medical information disclaimer
Better Health Questions is an independent educational publication. It does not provide medical care, diagnosis, treatment recommendations, legal advice, or insurance representation, and it is not affiliated with any former business that may have used this domain. This page is for general educational purposes only. Always discuss your specific situation with a qualified healthcare provider before making a healthcare decision.
By Better Health Questions Editorial Team. Last updated September 8, 2026.