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#157 Realistic Choice, Shared Decision Making and planning ahead: what evidence and experience tells us with Dr Jude Partridge
04/13/2026
#157 Realistic Choice, Shared Decision Making and planning ahead: what evidence and experience tells us with Dr Jude Partridge
What is realistic choice and how is this supported by shared decision making? I was privileged to ask Dr Jude Partridge, a consultant geriatrician with the POPS Team at Guys and St Thomas’ hospital these questions. Listen in to hear what the evidence tells us, how this can be operationalised and what a tremendous difference it makes. Resource mentioned in this episode Shared decision making in the Key messages Realistic choice means offering evidence‑based, tailored options that are genuinely appropriate, not an “illusion of free choice”. Shared decision making ensures patients understand realistic options, benefits and harms, then choose based on their own values. Shared decision making is now a legal standard in the NHS personalised care model. Clinical encounters are power‑imbalanced, we need honest, open communication to level this. Decisions should follow a holistic assessment (frailty, comorbidities, cognition, function, values). “Just because we can, doesn’t mean we have to” – non‑intervention can be the most appropriate care for a person. Shared decision making also means positively recommending treatment when it supports what matters most. Shared decision making relies on strong communication skills and data‑driven discussion of risk and outcomes. Evidence shows benefits for patients and systems. People in more deprived areas may benefit especially from shared decision making. There is a need for better public health messaging on realistic choice and shared decision making. For information about Advance Care Planning, see the resource on my Find out more about how I can work with youIf you are a team looking to provide better end of life care, or set up a one off or complete education programme in end of life care head to where I provide details on how I can help you. You will also find information about my Lasting Power of Attorney consultancy and the talks I offer for organisations. If you enjoy the episode or learn something new, please consider buying me a coffee to go towards making more valuable podcasts:
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