Engagement-sensitive decision making: Training doctors to sustain patient engagement in medical consultations

Questioning about "how to talk with patients" and how to make them engaged in healthcare decision making is currently a policy imperative for Western healthcare systems. Making patients active participants of their care process is increasingly advocated as an ideal model for medical consultations, as it has the potential to deliver better health outcomes and a more efficient use of resources through retaining patients’ autonomy and self-determination. However, beyond the evident benefits of patient engagement in healthcare, it should be also considered that doctors - in their daily practice - are commonly challenged by the diversity of situations that arise when they attempt to engage health consumers in clinical decision making. Indeed, consistently engaging patients in daily clinical practice asks doctors to be able to recognize that patients’ different clinical statuses and engagement dispositions might require different relational styles. Clearly, different situations require different communication approaches and doctors should be trained to adapt their relational style according to the specificities of such situations. This chapter will be devoted to discussing the opportunities offered by an "engagement-sensitive decision making" in order to orientate doctors’ relational skills and decisional style according to patients’ needs at each phase of the health engagement process. Insights for medical education and the potential value of new technologies aimed at improving doctors’ relational strategies to improve patient engagement will be also provided