Primary Care Physician Perceptions of Shared Decision Making in Lung Cancer Screening

In America, The Centers for Medicare and Medicaid Services supports lung cancer screening with annual low-dose computed tomography for patients who engage in shared decision making (SDM). Unfortunately, SDM and screening rates in primary care are low and as a result, the potential benefits of lung cancer screening are not being realised. This research team interviewed primary care physicians in a large urban medical centre about their views of SDM and lung cancer screening. Results of interview analyses revealed major themes and subthemes, showing that physicians were aware of lung cancer screening but believed that they and their patients would benefit from more information about screening guidelines. Doctors were aware of SDM its potential to identify patient priories and factors that affect their receptivity to screening. Many physicians expressed concerns about the time required for SDM given competing priorities. They also identified the challenge of engaging patients in SDM, especially those with low health literacy. Most physicians expressed a desire to receive training in SDM. Findings from this study indicate that primary care physicians understand the importance of SDM, however healthcare systems and physicians alike must take steps to support SDM and lung cancer screening in primary care to reduce the burden of lung cancer and improve patient outcomes.

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