{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:58:56Z","timestamp":1794002336212,"version":"4.8.0"},"reference-count":48,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,25]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To elicit the benefits of shared decision-making to doctors who are champions of this approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative interview study that used practical thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We identified a purposive international sample of doctors in active clinical practice who were recognised champions of shared decision-making, working in various clinical disciplines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>24 doctors in active clinical practice were interviewed; 14 were male and 10 were female; 20 had been in clinical practice for over 10 years (range 1\u201330). 12 practised in North America, 10 in Europe, 1 in South America and 1 in Asia; 4 doctors worked in internal medicine, 4 in primary care, 5 in surgery, 3 in paediatrics, 3 in oncology and 1 in each of the following disciplines: emergency medicine, palliative care, geriatrics, physical medicine and rehabilitation, anaesthesiology, and cardiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This selected sample of doctors consistently reported that shared decision-making provided benefits to themselves, their patients and their teams. Shared decision-making reinforced and enhanced their self-identity as ethical professionals, supporting patient autonomy, increasing their professional fulfilment and reducing their risk of burnout. These intrinsic benefits accompanied reports of other consequential benefits, namely, patients\u2019 achieving better-informed, preference-sensitive decisions, a higher likelihood of improved patient outcomes, improved efficiency and team function. The doctors viewed the approach as providing connectedness, shared responsibility resulting in a lighter burden, acting as a buttress against moral injury and the emotional strain of clinical work and, where relevant, mitigation against becoming the second victim of a bad or unexpected outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>Doctors who champion shared decision-making report significant benefits to themselves and their patients. These benefits have not been widely reported, which has implications for motivating doctors to adopt shared decision-making. Instead of addressing presumed gaps in communication skills, it might be better to highlight the positive impact on professional fulfilment and the protective effect of shared decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107732","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T06:10:57Z","timestamp":1766643057000},"page":"e107732","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["\u2018A return on investment\u2019. 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