The power of regret in medical decisions:
We know that regret is a powerful emotion and the desire to avoid regret can drive decisions. Backcasting is a technique that can be helpful in exploring the potential impact of regret. Dr. O’Brien, an orthopedic surgeon, has started to apply the technique for patients who have a shoulder injury (e.g. rotator cuff tear) and are deciding whether to operate or try non-surgical approaches. He will ask patients the following: 

Let’s say we don’t do surgery now and in 6 months you find that your function and pain are getting worse. How would you feel – kicking yourself that you didn’t have surgery earlier or glad that you tried to let it heal without surgery?”

Dr. O’Brien has been surprised at the difference in conversations when using this approach. “The technique provides insights into my patients’ decision making that I wouldn’t have otherwise discovered – for many there is a strong action bias toward surgery but for others, it reveals satisfaction with the status quo.”

Interested in learning more practical SDM tips and techniques? Check out our updated Harvard Medical School course on Shared Decision Making: Skills for Clinical Practice 

*Risk management, CME and CEU credit provided*

Contact us if you have any questions or if you are interested in group discounts for the course.