Take Part in Care Decisions Without Losing Your Priorities

Editorial boundary: This guide supports a conversation with your care team. It does not recommend an option, calculate your personal risk, or tell you to start, stop, or delay care.

A healthcare decision is rarely just a list of pros and cons. The evidence matters, and so do your goals, daily responsibilities, past experiences, cost or access limits, and comfort with uncertainty. Shared decision-making brings those parts into the same conversation.

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First gather the facts with the one-page health story. Then use the phrases in Speak Up and Be Understood when you discuss the options.

Name every reasonable option

Ask the clinician to name the options that are reasonable for your situation. Depending on the decision, that may include another test, a different treatment, a period of monitoring, or getting more information before deciding. “Wait” is not always safe, and “do something now” is not always the only choice. The care team must explain what applies to you.

• What are the available options?
• Why is each option being considered?
• Is there a time limit on the decision?
• What could happen if I wait?
• What would make one option clearly unsuitable?

AHRQ’s SHARE Approach describes shared decision-making as a dialogue about options, benefits, harms, risks, and what matters most to the patient.

Separate benefit, harm, burden, and uncertainty

These four columns answer different questions. A benefit is the improvement an option may offer. A harm is an unwanted medical outcome. A burden is what the option asks of your time, comfort, money, travel, or caregiving support. Uncertainty is what the available evidence cannot tell you.

When numbers are used, ask what they mean for a group like yours and over what time period. “Cuts risk in half” can sound large, but it means something different when a risk changes from 20 in 100 to 10 in 100 than when it changes from 2 in 10,000 to 1 in 10,000.

Put your priorities on the record

The care team cannot weigh a priority it does not know about. Say what you are trying to protect or improve. Examples include staying alert for work, avoiding a long recovery, caring for another person, preserving mobility, reducing pain, becoming pregnant, or limiting out-of-pocket cost.

“I understand the medical goal. My biggest concern is how this option may affect ____. How should that change the comparison?”

NIA’s checkup question guide encourages asking how a condition or plan may affect your life and requesting clear explanations of tests and medicines.

Know when more explanation is needed

Ask what evidence supports the recommendation and whether the answer is strong, mixed, or limited. Ask whether important groups were underrepresented in the research. If the decision depends on a test, ask what a positive, negative, or unclear result would change.

AHRQ’s QuestionBuilder can help organize questions before the appointment. You can also use AHRQ’s teach-back guidance to say the comparison back in your own words.

Use a support person without giving away your voice

A trusted person may listen, take notes, or remind you of a priority. Decide together whether they may ask questions and whether there are private topics they should step out for. NIA’s appointment-preparation guidance notes that bringing a family member or friend can be useful when you agree on the role in advance.

Ask about a second opinion

A second opinion may be useful when the decision is major, the diagnosis is uncertain, options carry serious tradeoffs, or you still do not understand why one path is preferred. Ask whether waiting for another opinion creates a meaningful risk, what records are needed, and how coverage or referral rules work.

A second opinion is another clinical assessment, not a guarantee that you will hear the answer you prefer. Bring the same question and records so the comparison is fair.

Close with a review point

Some choices can be revisited; others are difficult to reverse. Before agreeing, ask what success will look like, when it will be checked, what warning signs need urgent attention, and what would prompt a change in plan.

If the choice feels urgent or unsafe, contact the treating team or appropriate emergency service. Do not use this publication to delay needed care.

Write down the choice in your own words. Include the date and the next review point. If you have not decided, record what fact or conversation is still missing. This makes the next step clear without pretending that every hard choice can be settled in one visit.

Production note: This article used AI-assisted drafting from sealed source material and was independently checked against the cited evidence before publication.