The New Subjective Medicine: Understanding the Patient’s Worry Improves Shared Decision Making and Increases Compliance

often argue that when no or very small risks are involved, people are still worried and that a possible reason for this is lack of trust. However, worry has not been focused upon to the same extent as level of risk. Decision counseling may clarify personal preferences related to health behavior choices and thus facilitate achievement of the ideals of informed and shared decision making. Examples of decision counseling on risks in the medical context, as described by Myers [4] and others, include cancer prevention and control where provider and patient identify personal values associated with decision alternatives. Another example is the treatment of rheumatoid arthritis, which implies a succession of single or multiple drugs with decision points when the next drug is chosen [5] . Therefore, risks and worry must be considered repeatedly. Rheumatoid arthritis gives different symptoms including pain and disability. Should the worry about pain or disability, or both, constitute the basis for the process of the decision and the assessment of outcomes? What is the estimate of probability that one or both of the symptoms will decrease with the treatment chosen? How are pain and disability experienced subjectively by the patient? For the doctor disability is more apparent and objective, whereas the pain, which is subjectively experienced by the patient, might be more difficult to assess. Another example is the patient Physicians may not value different outcomes in the same way as patients. Therefore, a new more subjective medicine taking the patient’s point of view on health care and health should include cognitive as well as emotional components. Health was viewed as an objective biological fact in the past. However, it has increasingly been argued that patient values must be respected in health care decisions with an increased interest in the subjective health [1] . The task of the health provider is to consider the probability of obtaining certain health outcomes, and weigh the value of an outcome by the probability with which it will occur; this information forms a basis for decision making for both the patient and the provider. Recent research into health [2] has focused upon values with perceptions of pros and cons of health. However, a broader view of health also mandates the inclusion of beliefs about health-related issues. The assessment of health beliefs may help providers to understand their patients’ treatment behavior and facilitate treatment engagement and compliance. Beliefs about the likely outcome of different treatments might vary among doctors and patients. Incorporating patients’ beliefs about these outcomes into decisions is thus of importance. Health beliefs are sometimes related directly to perceived risk and sometimes to worry [3] . Perceived level of risk calls for a more intellectual judgment, and worry refers to emotional reactions. Experts