[Patient involvement: the physician's view--a qualitative survey]

Patient involvement (PI) and shared decision making (SDM) have increasingly come into the focus of (inter-)national research. SDM, however, is not a standard component of standard care so far. Therefore it is of importance to take into consideration all parties concerned. This article points out the barriers physicians see; one group has not been interrogated on this topic often.

25 physicians at a clinical centre were interviewed about decision-making processes within their environment, their concerns as well as their ideas towards PI. The consultations were realized with the help of a guideline-oriented questionnaire. The outcome was then interpreted by means of the thematic content analysis.

A system of categories was constructed containing 28 categories on the micro-, meso-, and macro-level. From a physician's perspective, changes are necessary on all levels to achieve patient involvement and SDM. Essential points of approach for this are: sufficient time and personnel, sufficient communicative abilities in physicians, and a solid physician-patient relationship as well as changes in healthcare politics.

To consistently improve patient involvement and SDM, physicians' concerns must be taken seriously. Here SDM can only be properly applied by taking into account the meso- and macro-level. Furthermore, it would be helpful to clear up the conceptually vague aspects of SDM, which would also help to communicate the concept more clearly.