The Power of Shared Decision Making in MSK Care

Musculoskeletal (MSK) conditions affect millions, impacting mobility, independence, and overall quality of life. Yet too often, patients are placed on a predetermined treatment path without fully understanding their options or role in the process. Some assume surgery is the only choice, while others delay care or disengage, missing treatments that could improve their health and function.

Shared decision making (SDM) changes that. SDM is a structured, evidence-based process designed to ensure that patients are engaged, informed, and actively participating in their care. In practice, it is collaborative conversations between a patient and a care navigator experienced in MSK. Together, they consider the patient’s health history, goals, and lifestyle, discuss treatment options, and weigh the risks and benefits of each path, providing a clear framework of next steps and expectations. 

This not only allows the patient to actively participate in their care, but empowers them to make the most informed decisions for their health.

Studies, including research from Dr. Chad Cook, a member of TailorCare’s Clinical Advisory Board, show that SDM improves patient engagement and adherence to treatment plans, leading to better long-term outcomes and more effective care management strategies.

At TailorCare, we’ve seen firsthand the impact of engaging patients in their own care. Through clinician-led conversations, evidence-based tools, and ongoing support, we ensure that every patient has a clear understanding of their care pathway, helping them stay engaged and confident in their health decisions. 

As a result, early data shows that in 2024:

• More than 70% adhere to their recommended treatment plans, leading to better outcomes and happier patients.
• Patients reported an NPS of +90 and a 4.8 patient satisfaction score.
• 90% report improvements in pain or function.
• Surgical episode costs decreased 13%, with a shift to more favorable sites of care. 
• Prior Authorization denials decreased 75%, improving access to appropriate care.

Why Isn’t Shared Decision Making the Standard?

Despite its clear benefits, shared decision making is still not widely used in MSK care. Many healthcare workflows are not designed to support the in-depth discussions SDM needs, adding to high rates of unnecessary surgeries, poor adherence to clinical pathways, and patient frustration.

Several barriers prevent SDM from becoming standard practice:

• Time constraints. Providers have limited appointment windows, making it difficult to walk patients through all their options.
• Lack of financial incentives. Unlike procedures, SDM isn’t reimbursed, making it harder for providers to justify the additional time investment.
• Training gaps. Effective SDM requires specialized communication skills, but most providers haven’t received formal training.
• Narrow treatment focus. Many MSK providers focus on a narrow set of treatments, which can restrict conversations about alternative options.

Traditionally, medical decision-making has been driven by providers directing treatment plans for patients rather than involving them in the process. This approach assumes that providers alone are best equipped to determine the right course of action, often overlooking patient preferences, values, lifestyle, and personal goals.

While patient-centered care is becoming more common, many healthcare systems still operate under a provider-led model that limits patient involvement. SDM models like TailorCare’s shift that dynamic by ensuring that patients play an active role in their care decisions.

Without addressing these barriers, SDM will remain underused, leaving many patients without the knowledge and support they need to make informed choices about their health.

What Happens When Patients Are Left Out?

When patients aren’t involved in making decisions about their care, they lose the chance to ask important questions, explore their options, and prepare for the realities of treatment. This can lead to surprise, confusion, and frustration when patients face unexpected challenges during recovery, post-treatment care, or in how their clinical outcomes unfold.

For example, many patients assume that joint replacement will provide immediate relief, only to be caught off guard by the long recovery, lingering stiffness, and the need for post-operative rehabilitation. Without clear guidance upfront, it’s easy to feel discouraged or even regret the decision, one in three often do. 

Patients who don’t fully understand their treatment plans are more likely to struggle with follow-up care, make additional unplanned visits, and experience preventable complications. This can erode trust in their providers and the healthcare system while driving up higher utilization and unnecessary costs.

But when patients actively participate in their care—supported by a trusted clinician who guides them impartially through their options—they report better outcomes, higher satisfaction, and greater confidence in their care plans. They understand what to expect, follow through with their treatment plans, have ongoing support when they need it, and ultimately see better outcomes. It creates a more efficient and effective system for everyone involved.

How TailorCare Puts SDM into Practice

At TailorCare, SDM has been a core part of our approach from the start. It’s the foundation of how we deliver MSK care. From the very first conversation, we focus on building a trusted relationship with the individual to ensure engagement, support education, and develop personalized care pathways. This guarantees that our members receive the right care at the right time from the right provider.

Our model is built around:

• Clinical Navigators. Licensed physical therapists with specialized training in SDM, including coursework from Harvard University, engage with patients one-on-one. Using a structured, evidence-based intake, they assess health history, deeply explore symptomatology, collect patient-reported outcome measures, and establish patient goals and preferences to guide patients toward the best treatment options for their needs and desires.

• Evidence-based guidance. Established clinical guidelines and research-backed processes ensure patients receive high-value, effective care. Each patient is presented with a structured overview of their options, with clinical best practices informing our recommendations.

• Matching patients to the right providers. By considering clinical expertise, treatment availability, and patient preferences, we ensure that patients receive high quality care from specialists who align with their condition and goals.

• Ongoing support. We maintain structured follow-ups to track progress, answer questions, and adjust treatment options as needed, keeping patients engaged and supported throughout their entire treatment journey.

• Measurable outcomes. Continuous tracking of patient-reported data allows us to refine care pathways, improve engagement, and ensure treatments align with each patient’s needs and goals. By prioritizing shared decision making, we see sustained improvements in patient experience, functional outcomes, and care efficiency.

Rather than defaulting to high-intervention treatments like surgery, or delaying the treatments they need to get better faster, TailorCare ensures that patients fully understand their options and actively participate in choosing the best path forward. 

The Impact of Informed Decisions

For many patients, SDM is life changing. Take Cheryl, for example. Her physician told her that surgery was the only option for her hip pain. Through a structured SDM conversation with a TailorCare Clinical Navigator, she learned about an alternative pathway: physical therapy coupled with a home exercise program. 

That thoughtful, guided conversation gave her “hope” when she felt lost. With expert support from her Clinical Navigator, she committed to her new treatment plan, and after just a few physical therapy sessions, she was back to taking her daily walks without an unnecessary procedure.

Cheryl’s experience reflects what TailorCare delivers every day: the right treatment, at the right time, with the right provider. Thousands of patients have regained mobility, reduced pain, and improved their quality of life by following the right treatment path through TailorCare—one that fits their needs and is backed by evidence-based guidance.

Setting the Standard for SDM in MSK Care

SDM should be the standard of care, not the exception. Yet many healthcare systems still operate under outdated provider-led models, leaving patients without the support and education they need to make the best decisions for their health.

At TailorCare, we’re changing that. By embedding SDM into every stage of the MSK care journey, we ensure that patients feel supported, providers have the tools to guide them effectively, and health systems see better outcomes.

For patients, SDM points to greater confidence, leading to higher satisfaction and improved long-term results. For providers and health plans, it leads to fewer unnecessary procedures, a more efficient use of resources, and more importantly, increased adherence to evidence-based treatment pathways. TailorCare is seeing this firsthand.

Rather than working around the usual barriers, we’ve built a model that removes them. With expert clinical guidance, structured decision-making frameworks, and ongoing support, TailorCare sets a new standard that strives for every patient to get the right care at the right time while staying engaged throughout their recovery.