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Birnie and Robinson have provided a valuable overview of the complexity of treatment decision making in localized prostate cancer.1 As a clinical nurse specialist at the Manitoba Prostate Centre in Winnipeg, my work focuses on working with newly diagnosed men with prostate cancer to help them and their partners come to treatment decisions. I spend an hour or more with these couples and over and over I hear that the men have gone to their trusted family physicians and asked the question, “What would you do, Doc?” And despite the evidence presented in Birnie and Robinson’s article, most men tell me their physicians respond, “Well, I’d have ….” The problem with this well-meaning response is that it is personal and based on the physician’s values—not the patient’s.
The article by Birnie and Robinson clearly points out value of clarifying the patient’s values, providing unbiased information, and not presuming to know what the patient considers important. The next time someone asks you, “What would you do, Doc?” please consider the value of your hypothetical response.