Shared Decision-Making Framework for Pelvic Examinations in Asymptomatic, Nonpregnant Patients

Controversy exists regarding whether to perform pelvic examinations for asymptomatic, nonpregnant patients. However, several professional organizations support the notion that health care providers should no longer recommend that asymptomatic patients receive a yearly pelvic examination. At minimum, health care providers must respect patients' autonomy in decision making around this examination and initiate a joint discussion about whether to proceed with a pelvic examination. Shared decision making is a model used in other aspects of medicine that can aid such discussions. This model recognizes two experts in these clinical encounters-the health care provider is the expert regarding medical information and the patient is the expert regarding their values, preferences, and lived experiences. When shared decision making is used, not only is each expert valued for their knowledge, but the power differential shifts to a shared power model. This commentary aims to educate about shared decision making, explain why shared decision making is appropriate to use when discussing whether to perform a pelvic examination, and provide a framework for using shared decision making in discussing whether to proceed with a pelvic examination with asymptomatic, nonpregnant patients.