Shared Decision-making on Medical Tests and Care Cascades

Medical tests may show unexpected findings leading to additional tests, treatments, and visits that cost money and take time but may not have benefits. This is a prevalent issue with major consequences for patients and clinicians. Making informed decisions about when to order medical tests may help avoid unnecessary costs and worry. However, doctors don't always have detailed conversations about medical testing and there are patient gaps in knowledge. The investigators hypothesize that education materials and peer comparison to promote conversations about medical tests will improve conversation quality about medical testing decisions. The investigators have developed patient and provider-facing interventions to educate on and promote conversations about the uses and consequences of medical tests, and the investigators will test the impact of this just-in-time educational and peer comparison intervention on the likelihood of patients having productive conversations about medical tests. The effects of the intervention will be assessed using surveys before and after the study. This work has the potential to help patients feel more supported by their healthcare system, empower patients to participate in shared decision-making, and build trust between patients and clinicians.

Inclusion criteria

(Physicians):

• Primary care physicians at Brigham and Women's Hospital
• In active practice

Inclusion criteria

(Patients):

• Adults age 18 years old or older
• English-speaking
• Access to email
• Did not opt out of receiving research invitations from health system
• Patients of participating physicians
• Scheduled annual physical during the study period