Evidence-based patient choice: inevitable or impossible?

This well designed book is clear, accessible and, as one would expect from the title, evidence-based. Contributors to the book are clearly identified at the beginning with a short biography about each, which helps to establish credibility. Contributions originate from Australia, Canada, Germany, Great Britain, The Netherlands and the USA—and are from acknowledged experts in the field. The book concentrates on individual choice, but sensibly recognizes the wider implications of health care delivery to populations. The first chapter (written by the editors) provides a brief résumé of what is to come. This is useful for those who wish to dip in and out when searching for opinion and evidence relating to more specific areas. The ‘story’ begins with setting the scene on the development of the evidence-based health care movement. This is followed by a discussion relating to the challenge of individualizing this care and involving our patients in the decision. It challenges us to consider the implications of how much involvement our patients need. Then three chapters discuss the theoretical basis for evidence-based patient choice (EBPC). These cover the ethical issues, the health economics and the dilemmas of dealing with knowledge and uncertainty. Section three comprises four chapters. They cover patient-centredness in medicine, shared decision-making principles and the discussion we have with patients communicating risk. The section finishes with a chapter on decision analysis. By now, you will be noting that huge areas are being compressed into what is, overall, quite a short book. The next section discusses EBPC in practice. One chapter concerns primary health, another secondary care, and there is a chapter on narrative and patient choice. The final section really moves us to the future, looking at education, training and research implications for health care professionals. It also covers consumer health informatics in the Internet age. I think this is a great book that challenges clinicians and others working in health care to develop and adapt to a rapidly changing and demanding world. Can we do it with support from patients? The answer is in the book!