Recently, the Centers for Medicare & Medicaid Services (CMS) finalized a proposal to reimburse providers for end-of-life counseling as part of advanced care planning. This was in response to a push to further engage patients, families and surrogates in their medical care decisions and improve overall access to these important services. Hopefully, this will encourage more perioperative providers to have difficult conversations with some of the most medically complex surgical patients undergoing high-risk procedures. Anesthesiologists, as perioperative care physicians, have an important role in shaping the future of surgical shared decision-making (SDM) – that is, helping patients reach an optimal decision about their care that takes into consideration the latest research, available options and the patient’s own values and preferences. Better incorporation of patient preferences should lead to improved patient experience, greater levels of engagement and less decisional conflict. In fact, a high-quality decision related to the appropriateness of care...

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