PHOTOS: Shared Decision Making

By Heidi de Marco

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The Patient Support Corps at UC San Francisco Medical Center pairs interns with patients to provide support during visits. A sign with the student’s face hangs outside the exam room to remind patients to call their assigned note-taker (Photo by Heidi de Marco/KHN).
Rose Gutierrez, 52, gets her vitals taken at UC San Francisco on Wednesday, February 11, 2015. The caregiver from Merced was diagnosed with cancer last spring after a mammogram and needs to make a decision about further treatment (Photo by Heidi de Marco/KHN).
Dr. Jasmine Wong, a surgeon at UC San Francisco, explains treatment options to Gutierrez. A small red USB audio recorder sits between them and captures the conversation (Photo by Heidi de Marco/KHN).
Etienne Gallant, a student intern for the shared-decision program, sits quietly in the corner of the exam room typing notes for Gutierrez on a laptop (Photo by Heidi de Marco/KHN).
Gutierrez waits to be examined by plastic surgeon Robert Foster and Dr. Jasmine Wong. Gutierrez recently had a lumpectomy and underwent 10 weeks of chemotherapy, but the cancer is still present (Photo by Heidi de Marco/KHN).
Gutierrez lies on the exam room table while Dr. Wong examines her breasts. Gutierrez needs to decide between getting another lumpectomy, followed by radiation, or a total mastectomy (Photo by Heidi de Marco/KHN).
Gutierrez says she is not too concerned about keeping her breast, but is worried about how her body will react to radiation (Photo by Heidi de Marco/KHN).
Dr. Foster explains different reconstruction options to Gutierrez. If she chooses to have a total mastectomy, Foster says she can use her own tissue to replace lost breast tissue or get implants (Photo by Heidi de Marco/KHN).
Gallant, 22, returns to the exam room to give Gutierrez a CD with the audio recording of her appointment. “People have so much information thrown at them. You can go over the recording…so you have an understanding,” Gallant says (Photo by Heidi de Marco/KHN).
The CD patients receive after a medical appointment, along with other aides, are intended to help them be actively involved in the decision-making process (Photo by Heidi de Marco/KHN).
Gutierrez ultimately decided a mastectomy was the best option for her. She says she felt good about making the decision together with her doctors (Photo by Heidi de Marco/KHN).

Shared decision making programs encourage doctors and patients to work together in making tough choices about care at UC San Francisco.

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