If you work in primary care today, odds are good that you’re seeing patients with multiple chronic conditions. Individuals with combinations of diabetes, high blood pressure, arthritis, and depression are rapidly becoming the norm in outpatient offices and clinics. And even if a provider and patient work together to choose the right medications and agree on making some lifestyle changes that will improve health, the best-laid plans often fall apart. Labeling patients “noncompliant” has been a tempting response but, many argue, is pejorative and tends to obscure what’s really going on – especially if one starts to better appreciate the unique and day-to-day burdens of being a patient with chronic disease.

  

There’s a lot of work underway on multiple fronts to advance shared decision making, but one of the freshest, most innovative voices is that of Dr. Victor Montori, who lead the conversation on this program of WIHI, "New Tools and Thanking for Shared Decision Making." Dr. Montori, who’s already carved out the idea and practice of Minimally Disruptive Medicine, still wants to provoke. He talks about the need for a patient revolution and says “health care has to compete with life.” And “life” in the case of a patient can mean anything from not being able to afford medications, to not having the time to take them, to not being able to focus on one’s own health because of stresses at home or another family member’s health crisis.