Physicians' attitudes about shared decision making for XXXX screening.

@entity1 @entity263
BACKGROUND AND OBJECTIVES: Shared decision making (SDM) for @entity263 screening (PCS) is recommended for physicians and @entity1 due to the uncertainty regarding the risks and benefits of screening. METHODS: We assessed primary care physicians' attitudes and specific factors that may influence the SDM process, including level of training and practice setting. @entity1 included academic clinicians (n=16), interns/residents (n=84) and community clinicians (n=35). Physicians completed a 26-item survey that assessed attitudes about the SDM process for PCS. RESULTS: More physicians endorsed SDM (47.4%) or the @entity1 deciding (35.6%), while few physicians wanted to decide for their @entity1 about screening. However, 54.8% endorsed an annual PSA as the standard of care. Most felt that decisions should be based on full disclosure of the risks and benefits of testing (93.3%), and few believed that the sensitivity and specificity of the PSA was adequate (36.6%). Across all physicians, lack of time, competing health demands, malpractice fears, and @entity1 interest were all commonly cited as potential factors that influence the SDM process. Compared to academic clinicians and interns/residents, community clinicians were more likely to endorse annual screening, to be concerned about malpractice, and to agree that PSA sensitivity and specificity are acceptable. CONCLUSIONS: Our findings demonstrate physician, @entity1 and systemic factors regarding the PCS decision. Further effort is needed to overcome the barriers of engaging @entity1 in SDM if we want to truly promote effective SDM for PCS, as espoused by national guidelines.
