Shared decision phrases, not a menu read aloud

How to use this phrase bank

These are examples of natural wording, not scripts. Examiners mark what you do for this patient, and a memorised line delivered without listening often sounds worse than plain words of your own. Read them, pick two or three that sound like you, and practise saying them in your own way. The “avoid” versions are common habits we hear in practice consultations; each comes with the reason it tends to fall flat.

Making the choice clear

Many patients assume the doctor decides. Say plainly that there is a choice.

• Try: “There isn’t one right answer here. It depends on what matters most to you.”
  Avoid: “I’d recommend we start the tablets.”. Recommending can be right, but if the choice is genuinely open, say so first.
• Try: “There are a few ways we could go with this. Can I talk you through them?”
  Avoid: “Your options are A, B or C. Which one?”. A bare list with a demand for an answer is not shared, it is delegated.
• Try: “Doing nothing for now is also a reasonable option.”
  Avoid: “(Leaving out watchful waiting.)”. Not treating is often a valid choice and patients rarely know it is allowed.
• Try: “You don’t have to decide today.”
  Avoid: “So, what do you want to do?”. Pressure to decide on the spot can push people into a choice they regret.

Explaining the options

Give the main benefits and downsides of each, in their terms.

• Try: “The tablet would lower the chance of a stroke, but some people find it upsets their stomach.”
  Avoid: “The tablet is the best option.”. Benefits without downsides is persuasion, not information.
• Try: “With the injection, the pain usually settles faster, but it may come back.”
  Avoid: “Injections have lots of risks.”. Vague risks scare without informing.
• Try: “For someone who drives for work, the main thing to think about is…”
  Avoid: “(The same explanation for everyone.)”. Tailoring to their situation makes the options real.
• Try: “Here’s a leaflet that compares them side by side.”
  Avoid: “(Relying on memory alone.)”. A decision aid helps people weigh options at home.

Finding out what matters to them

The decision depends on their values, so ask.

• Try: “What matters most to you in all this?”
  Avoid: “I think you should go for surgery.”. Your preference is not their priority.
• Try: “How do you feel about taking a tablet every day?”
  Avoid: “You’ll need to take it every day, that’s fine, isn’t it?”. A leading question invites agreement rather than honesty.
• Try: “What worries you most about each option?”
  Avoid: “(Assuming you know their worries.)”. Concerns are often not what you expect.
• Try: “Is there anyone you’d like to talk this over with?”
  Avoid: “(Expecting a decision alone.)”. Many people make health decisions with family.
• Try: “Have you had experience of this before, in the family or with friends?”
  Avoid: “(Ignoring past experiences.)”. A relative’s bad experience often drives a preference.

Giving your view when asked

Patients often ask what you would do. You can answer honestly without taking over.

• Try: “If you want my view, I’d lean towards trying the tablets, mainly because of your family history. But it’s your decision.”
  Avoid: “Whatever you want.”. Refusing to give a view when asked is unhelpful; patients value an honest opinion.
• Try: “From what you’ve said about wanting to avoid hospital, the second option seems to fit better. Does that sound right?”
  Avoid: “What I’d do in your shoes is irrelevant.”. Linking your view to their stated values keeps the decision theirs.
• Try: “I can see why you’d choose that.”
  Avoid: “Are you sure? Most people would go for the other one.”. Social pressure is not shared decision-making.
• Try: “Some people in your position choose to wait and some prefer to start now. Both are reasonable.”
  Avoid: “Everyone has the tablets these days.”. Describing a range of choices helps; presenting one as the norm is pressure.

When you disagree

Respect an informed choice; stay clear about safety.

• Try: “I respect that it’s your choice. Can I just make sure I’ve explained the risk clearly?”
  Avoid: “That’s a really bad idea.”. Judgement makes people defensive and less likely to come back.
• Try: “I’m worried about that, and I’d like to tell you why.”
  Avoid: “Well, it’s your funeral.”. Sarcasm damages trust and is unprofessional.
• Try: “If you change your mind, the door is always open.”
  Avoid: “(Ending the conversation.)”. Keeping the option open makes it easier to revisit.
• Try: “Could we agree to check again in a month?”
  Avoid: “Fine, no treatment then.”. A review keeps the decision live and safe.
• Try: “Is there anything that would make the other option more acceptable?”
  Avoid: “(Pushing the same argument again.)”. Finding the barrier often unlocks a compromise.

Agreeing the plan

Summarise what was decided, and what happens next.

• Try: “So we’ve agreed you’ll try the tablet for three months, and we’ll check your blood pressure in four weeks. Does that sound right?”
  Avoid: “Right, that’s sorted.”. A clear summary confirms agreement and gives a timescale.
• Try: “What do you think about that plan?”
  Avoid: “OK? Good.”. Asking for their view of the plan gives them a chance to raise doubts.
• Try: “What might make it hard to stick to?”
  Avoid: “(Assuming the plan will happen.)”. Exploring barriers early makes the plan more realistic.

Practise saying them

Read a case brief, set a 12-minute timer and run it with a partner, the AI patient or out loud on your own. The Hot Seat holds the full case bank with a scorecard for each case. The Consultation Conversation Lab drills the Relating to others skills (cues, ideas and concerns, shared plans), and Worked Example Consultations show what a passing consultation sounds like from start to finish. Then put a few of these cases into your next mock exam.

Frequently asked questions

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