Every health choice needs two experts, and you can be one of them

Key takeaways

• Shared decision-making means you and your clinician choose together, blending the best evidence with your own values and daily life¹.
• A 2024 Cochrane review of 209 studies found that people using decision aids knew more and felt clearer about what mattered to them².
• Medicare requires a shared decision-making visit, with at least one decision aid, before a person’s first lung cancer screening scan³.
• More than 1 in 3 U.S. adults used a complementary approach such as yoga, meditation or massage in 2022, so these choices belong in the conversation⁴.
• A written list of the supplements and practices you use, plus four easy questions, can turn a short visit into a partnership⁵⁶⁷.

In 2002, about 1 in 5 U.S. adults used a complementary health approach such as yoga, meditation, massage or acupuncture⁴. By 2022, that share had nearly doubled to more than 1 in 3 adults, or 36.7 percent⁴. The figures come from a national survey analyzed by researchers at the National Institutes of Health (NIH)⁴. Meditation alone grew from 7.5 percent of adults to 17.3 percent over the same stretch⁸.

Those numbers do not even count dietary supplements. In a national survey from 2011 to 2012, about half of American adults took at least one⁹. Natural health is part of everyday life for millions of families.

So what happens when you sit down with a doctor to plan care for a long-term condition? Ideally, your preferences come into the room with you. A well-studied way of working called shared decision-making is built for exactly that. It makes you an equal partner in the choice.

Shared decision-making brings two kinds of expertise together

The Agency for Healthcare Research and Quality (AHRQ) is a federal research agency. It describes shared decision-making as a provider and a patient working together to reach a choice that fits the patient’s best interests¹. The best decision, AHRQ says, weighs evidence about the options alongside the clinician’s experience and the patient’s own values and preferences¹.

Think of it as a meeting between two experts. Your clinician knows the research and how each option tends to play out. You know your body, your schedule, your budget, your culture and the routines that help you feel well. Each half of that knowledge needs the other.

This matters most when there is more than one reasonable path. Living with a chronic condition brings many of those moments, often over many years. Is physical therapy, acupuncture or a gentle yoga class the right next step for your back? How do your vitamins and herbs fit with a new prescription? These are choices where your values can tip the balance.

AHRQ notes that family members and caregivers can be part of the process too¹. Bringing a trusted person to a big visit is a smart move.

Two simple models show what a good shared decision looks like

AHRQ’s SHARE Approach has five steps

AHRQ trains doctors, nurses and other clinicians with a model called the SHARE Approach. It breaks shared decision-making into five steps, one for each letter¹. When the agency worked with the University of Colorado to update the training, 9 in 10 clinicians agreed the approach was useful for daily practice¹⁰.

Step	What your clinician does	How you can help
Seek	Invites you to take part in the decision	Say that you want to be involved
Help	Helps you explore and compare options	Ask about every option, including waiting
Assess	Asks about your values and preferences	Share your goals and natural health habits
Reach	Reaches a decision together with you	Say which option fits your life best
Evaluate	Looks back at the decision with you	Report what you notice over time

Sources:¹¹⁰

The steps are worth knowing from the patient side. Once you know what a good conversation includes, you can gently steer toward any step that gets skipped. If your clinician moves straight to a prescription, for example, you might say, “Before we decide, could we talk through the other choices?”

Time is a common worry for both sides. AHRQ reports that, with training, clinicians can use shared decision-making without making visits longer¹.

The three-talk model maps the conversation

In 2017, a team of 21 researchers led by Glyn Elwyn published a simple map of a shared decision in the BMJ¹¹. They called it the three-talk model.

Team talk comes first. Your clinician lets you know that a real choice exists and offers support as you think it through¹¹. Your goals help guide everything that follows¹¹.

Option talk is the comparing stage. You and your clinician line up the alternatives side by side¹¹. The benefits and downsides are explained in ways that make the odds easy to understand¹¹.

Decision talk is where you arrive at a choice that reflects your informed preferences¹¹. The word “informed” matters here. Option talk exists to give you clear facts, so your choice rests on good information as well as your feelings.

For natural health, the three talks map neatly. In team talk, you can mention that you like to start with nutrition, movement or mind-body practices when it makes sense. In option talk, ask that those approaches be listed next to medicines and procedures. In decision talk, you and your clinician can build one combined plan that includes both.

Decision aids help people feel informed and clear

A decision aid is a tool that lays out your options and their likely benefits and downsides. It also helps you think through which of those matter most to you. It might be a booklet, a short video, a website or a one-page chart.

The biggest look at these tools comes from Cochrane, a network known for careful research reviews. Its 2024 update pooled 209 randomized trials that included 107,698 people facing 71 different health decisions². Those decisions ranged from heart treatments and joint replacement surgery to cancer screening and mental health care².

Compared with people who received usual care, people who used decision aids did better in several ways².

• They scored about 12 points higher, on a 100-point scale, on knowledge of their options.

• They were nearly twice as likely to have an accurate sense of their own risks.

• They felt better informed and clearer about which benefits and risks mattered most.

• They were about 28 percent less likely to sit back and leave the choice to the clinician.

• They were probably more likely to make choices that matched their informed values.

What about time? When people used a decision aid before the visit, appointments ran no longer. When it was used during the visit, the conversation ran about a minute and a half longer on average².

You do not need to wait for a clinic to hand you one. The Ottawa Hospital Research Institute in Canada keeps a searchable A to Z Inventory of patient decision aids on its website. In 2025, the institute updated its inclusion rules to apply version 5.0 of the International Patient Decision Aid Standards (IPDAS)¹².

The same research group offers the Ottawa Personal Decision Guide, a two-page form for tough health or social decisions¹³. It walks you through four steps:

1. Clarify your decision: what you are deciding, your reasons and when you need to choose.

2. Explore your options, including doing nothing, and rate from 0 to 5 how much each benefit and risk matters to you.

3. Explore the views of others involved, and notice whether anyone is putting pressure on you.

4. Identify your needs and plan next steps. Check whether you know the options, feel clear about your values, have enough support and feel sure of your choice.

Medicare builds shared decisions into some care

For a few services, Medicare makes shared decision-making a condition of coverage. That sends a clear message: your preferences are part of good care.

The best-known example is lung cancer screening with low-dose CT. Since 2015, Medicare has required a counseling and shared decision-making visit before a person’s first screening scan³. The visit must include one or more decision aids, and it must be noted in the medical record³.

The current rules took effect in February 2022³. They cover screening for people ages 50 to 77 who have no signs or symptoms of lung cancer³. People must have smoked at least 20 pack-years, such as a pack a day for 20 years³. They must also still smoke or have quit within the past 15 years³. The visit also covers coming back for yearly scans, how other health conditions affect the choice and, when it applies, support for quitting smoking³.

The American College of Radiology notes that this visit can happen on the same day as the scan¹⁴. It is also not subject to coinsurance or a deductible¹⁴.

In 2018, Medicare added a similar rule for some people considering an implantable cardioverter defibrillator (ICD). This small implanted device can shock the heart back to a normal rhythm. For certain patients, a formal shared decision-making conversation using an evidence-based decision tool must happen before the first implant¹⁵.

Your natural health preferences belong in the conversation

Back to the survey. The NIH analysis, published in JAMA in 2024, tracked seven approaches: acupuncture, chiropractic care, guided imagery or progressive muscle relaxation, massage, meditation, naturopathy and yoga⁴. Yoga use more than tripled, from 5.0 percent of adults in 2002 to 15.8 percent in 2022⁴. Among people who used any of these approaches, nearly half (49.2 percent) used them for pain in 2022⁴. That was up from 42.3 percent in 2002⁴.

These choices reflect what people value: movement, calm, hands-on care and an active role in their own well-being. The National Center for Complementary and Integrative Health (NCCIH) at NIH encourages people to talk about them openly. Its advice is clear and practical⁵:

• On your patient history form, list everything you use, from acupuncture to zinc.

• At each visit, tell your providers what you are using, and make a list ahead of time to take with you.

• Before you begin a new practice, ask about safety, how well it works and possible interactions with your medicines.

• Don’t wait for your providers to ask. Bring it up yourself.

NCCIH’s guidance on dietary supplements ties this straight to shared decisions. Talk with your providers about the approaches you use, it says, because “together, you can make shared, well-informed decisions”⁹.

Bring your list

The NIH Office of Dietary Supplements (ODS) suggests keeping a complete record of every supplement and medicine you take⁶. For each product, write down the name, the dose, how often you take it and why you take it⁶. Share it with all your providers, including doctors, dentists, pharmacists and dietitians⁶.

A list does a lot of work in a short visit. Your clinician can see the whole picture at a glance, and your care team can fit everything together. A smart time to update it is before any surgery, since NCCIH advises telling your surgical team about every dietary supplement you take⁹.

Smart use, built into the plan

When a supplement becomes part of your shared plan, a few habits help you and your clinician judge it well.

• Ask about amounts. ODS suggests asking about the right dose, and how, when and for how long to take it⁶. Your clinician or pharmacist can point you to the amounts used in research.

• Look for quality seals. Independent groups such as U.S. Pharmacopeia (USP), NSF International and ConsumerLab.com test products. Their seals show a product was properly made, contains the ingredients on its label and has no harmful levels of contaminants⁶.

• Give it time. Many supplement studies run 8 to 12 weeks, so agree on a check-in date and a simple way to track how you feel.

A short sample: how to raise a preference

Many people are unsure how to start. Here is one way it might sound for someone living with stiff, achy knees.

“Before we settle on a plan, I’d like to share what matters to me. I want to stay as active as I can, and I’d like natural approaches to stay part of my routine. Right now I do yoga twice a week, and I take fish oil and vitamin D. Here’s my list with the doses. Can we look at how these fit with what you’re suggesting? If we add something new, could we set a date to check how everything is working together?”

This works for several reasons. It names a personal goal, staying active. It shares the full list, so nothing is left out. It asks a question instead of making a demand, which invites the clinician’s expertise. And it sets up a follow-up, which matches the fifth SHARE step of evaluating the decision together¹.

Integrative care teams make partnership easier

Some health systems are built for this kind of conversation. NCCIH describes integrative health as bringing conventional and complementary approaches together in a coordinated way¹⁶. It aims for well-coordinated care among different providers and institutions, and its use has grown in care settings across the United States¹⁶.

In practice, your physician might work alongside a dietitian, an acupuncturist or a yoga teacher, all sharing notes and goals. Cancer treatment centers with integrative programs, for example, may offer services such as acupuncture and meditation¹⁶.

The Veterans Health Administration offers a well-known model called Whole Health. NCCIH explains that it moves away from a disease-centered focus toward a more personal approach that engages and empowers veterans¹⁷. It puts healthy changes in nutrition, activity, sleep, relationships and surroundings at the front of the plan¹⁷. Conventional testing and treatment are combined with complementary and integrative health approaches¹⁷.

Why does this help shared decisions? On an integrative team, asking about your values and natural health habits is part of the routine. Your preferences are expected and written into the plan from the start.

If your care is spread across several offices, you can still build a team. NCCIH suggests choosing a complementary practitioner as carefully as you would choose a conventional one¹⁸. Make sure that person is willing to work with your other health care providers¹⁸. Then tell all your providers, complementary and conventional, about all the approaches you use¹⁸.

Questions to bring to your next visit

A short set of questions helps you make the most of limited time. One of the easiest to remember is BRAN, promoted by Choosing Wisely UK. The campaign was launched in 2016 by the Academy of Medical Royal Colleges in the United Kingdom⁷. BRAN stands for four questions: What are the benefits? What are the risks? What are the alternatives? What if I do nothing⁷?

This fuller checklist builds on BRAN and adds your natural health priorities. Pick the ones that fit.

• What are the benefits of this option for someone like me?

• What are the risks or side effects, and how likely are they?

• What are the alternatives, including nutrition, movement or mind-body practices?

• What happens if I do nothing for now, or wait a while?

• How does this fit with the supplements and practices on my list?

• What amount is right for me, and how long should I give it before we check in?

• Is there a decision aid I can review at home?

• How soon do I need to decide?

• Could a dietitian, physical therapist or integrative clinician help with this plan?

• When will we look at how the plan is working?

Sources:⁵⁶⁷¹³

It is fine to leave a visit still unsure. The Ottawa Personal Decision Guide suggests next steps for that moment¹³. You might look for more information, write down your questions or talk with people who have faced the same choice¹³.

The bottom line

Shared decision-making turns a medical visit into a partnership. Your clinician brings the evidence and experience. You bring your values and the natural health practices that help you feel your best. A large Cochrane review of 209 trials found that tools supporting this partnership help people feel informed and clear about what matters to them².

You can start at your very next appointment. Bring your list of supplements and practices, jot down your BRAN questions and say out loud what you hope for. A good care team will welcome it, and an integrative team will build it right into your plan.

Sources

1. Agency for Healthcare Research and Quality. The SHARE Approach: Putting Shared Decisionmaking Into Practice. A User’s Guide for Clinical Teams. AHRQ. 2020. ahrq.gov

2. Stacey D, Lewis KB, Smith M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews. 2024. doi.org

3. Centers for Medicare & Medicaid Services. National Coverage Determination: Lung Cancer Screening with Low Dose Computed Tomography (LDCT) (210.14). Medicare Coverage Database. 2022. cms.gov

4. Nahin RL, Rhee A, Stussman B. Use of complementary health approaches overall and for pain management by US adults. JAMA. 2024. pubmed.ncbi.nlm.nih.gov

5. National Center for Complementary and Integrative Health. 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches. NCCIH. 2026. nccih.nih.gov

6. NIH Office of Dietary Supplements. Dietary Supplements: What You Need To Know. ODS. 2023. ods.od.nih.gov

7. Academy of Medical Royal Colleges. Choosing Wisely UK (BRAN questions). AoMRC. 2024. aomrc.org.uk

8. National Institutes of Health. NIH analysis reveals a significant rise in use of complementary health approaches, especially for pain management. NIH News Releases. 2024. nih.gov

9. National Center for Complementary and Integrative Health. Using Dietary Supplements Wisely. NCCIH. 2019. nccih.nih.gov

10. Agency for Healthcare Research and Quality. The SHARE Approach. AHRQ. 2024. ahrq.gov

11. Elwyn G, Durand MA, Song J, et al. A three-talk model for shared decision making: multistage consultation process. BMJ. 2017. doi.org

12. Ottawa Hospital Research Institute. A to Z Inventory of Patient Decision Aids. Patient Decision Aids Research Group. 2026. decisionaid.ohri.ca

13. Ottawa Hospital Research Institute and University of Ottawa. Ottawa Personal Decision Guide. Patient Decision Aids Research Group. 2025. decisionaid.ohri.ca

14. American College of Radiology. Low-Dose CT Lung Cancer Screening FAQ. ACR. 2023.

15. Centers for Medicare & Medicaid Services. Decision Memo for Implantable Cardioverter Defibrillators (CAG-00157R4). Medicare Coverage Database. 2018. cms.gov

16. National Center for Complementary and Integrative Health. Complementary, Alternative, or Integrative Health: What’s In a Name? NCCIH. 2021. nccih.nih.gov

17. National Center for Complementary and Integrative Health. Whole Person Health: What It Is and Why It’s Important. NCCIH. 2021. nccih.nih.gov

18. National Center for Complementary and Integrative Health. Are You Considering a Complementary Health Approach? NCCIH. 2016. nccih.nih.gov

This article is for general education and is not medical advice. Talk with your healthcare professional about your own health, especially before starting a new supplement if you are pregnant, nursing, taking medicine, or managing a health condition. Statements about dietary supplements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Reviewed October 2026.