After carefully eliciting patient values and reviewing their individual risk factors, it is important for the clinician to make a recommendation. As experts, many patients and families want clinicians to synthesize complex information into a recommendation that incorporates a patient’s situation with medical knowledge.

Notice how the clinician in this example does aspects of the following steps in making a recommendation:

1. Start by summarizing (or alluding to) individualized information about the patient.
2. Make the recommendation, supporting the recommendation with specific patient factors (e.g. values, health status).
3. Check for understanding.

Take a minute to think about what worked well in this example and what can be done differently.

• “Based on what I know about you, your health and what’s most important to you, I’d recommend…”
• “Let’s talk about what this means for you.”

White DB, Evans LR, Bautista CA, Luce JM, Lo B. Are Physicians’ Recommendations to Limit Life Support Beneficial or Burdensome?: Bringing Empirical Data to the Debate. American Journal of Respiratory and Critical Care Medicine. 2009;180(4):320-325. doi:10.1164/rccm.200811-1776OC.