Dr. France Légaré

Dr. France Légaré

Actively involving patients in care-related decisions is widely acknowledged as good practice these days. But it wasn’t always the case.

“As physicians, we generally used to make patients’ treatment decisions for them,” says Dr. France Légaré. “We essentially told them what we were going to do, rather than ask them what they wanted us to do.”

Recognizing the need to do things differently, Dr. Légaré has been a passionate advocate for patient engagement and empowerment over the course of her career — a tough fight at times. She recalls applying for a grant in the 1990s with colleague Dr. Annette O’Connor. The funding was to support the trial of a patient decision aid — a tool that helps people become involved in their health care decisions by providing clear information about choices to be made, options and outcomes, and clarifying personal values.

“Not only did we not get the grant, we were ranked last of all the applicants,” she says. “The reviewers couldn’t even understand what possible value we thought we might get from our project.”

An idea ahead of its time

The two decided to forge ahead with the development, translation and trials of their patient decision aid to help women reaching menopause make informed decisions about hormone-replacement therapy. The project was a success and, 10 years later, when they reapplied for the same grant to continue their research, their submission ranked first overall.

“There were times when it was difficult to sustain the motivation while we waited for society and the medical profession to catch up,” says Dr. Légaré. “But I’m so glad we did.”

In addition to her work developing decision aid tools, Dr. Légaré has also conducted extensive research on shared decision-making and its effect on the patient–physician relationship. She is the world’s  most-published author on the subject and has provided evidence to support the increased integration of shared decision-making into medical education, policy and health system reform.

Helping the next generation take the next steps

Dr. Légaré continues to teach new generations of medical students the importance of treating every patient as unique, even when they have the same diagnosis as others. She believes her work helped lay the foundation for this important evolution in medicine and finds it immensely satisfying to see younger physicians taking it even further.

“They don’t know anything else at this point,” she says. “Patient engagement is now so ingrained, such an expected norm that it couldn’t be any other way, and that’s exactly as it should be.”