Discussion | 253 11 patient-centered care is not merely a lofty ideal but a practical necessity. By aligning treatment plans with patients’ desires and values, we can anticipate a shift towards less invasive interventions and a prioritization of quality over mere quantity of life. While this thesis primarily delves into specific aspects of SDM, it’s crucial to acknowledge that there are myriad pathways to achieve patient-centered care. Embracing a holistic approach to medicine entails recognizing and valuing the diverse avenues through which patients can actively participate in their healthcare journey. In this vein, I wholeheartedly recommend Atul Gawande’s insightful book, “Being Mortal: Medicine and What Matters in the End33,” as essential reading for every physician (and I would definitely recommend his other books as well). Through poignant narratives and thought-provoking insights, Gawande navigates the complex terrain of end-of-life care, offering invaluable perspectives on the essence of patient-centered medicine. Initially, Gawande himself did not practice SDM, but he shares his own story about how he became more passionate about this approach, underscoring the transformative impact it can have on both patients and healthcare providers. This makes me believe that adopting SDM is possible, but it will certainly take time for physicians who have been practicing for a longer period to make this transition. Looking ahead, the horizon appears promising for the integration of SDM and patientcentered care into the fabric of Dutch healthcare. Notably, SDM has been integrated into the Dutch medical curriculum, marking a significant step towards prioritizing patient empowerment and involvement in healthcare decisions. Furthermore, the advent of artificial intelligence (AI) holds promise in augmenting these efforts, potentially serving as a valuable tool in facilitating SDM processes34,35. I hope to see all SDM tools integrated into patient records, with AI potentially reminding physicians during consultations to inform patients about these tools. Alternatively, AI could automatically identify the correct patients and send them the PDAs and information. However, please keep in mind that this should complement, not replace, the physician consultation. These patients are vulnerable, and while many tasks can be automated, they also need the opportunity to discuss their emotions, fears, and concerns with a real person. This personal connection is essential, as they will be seeing their oncologist for at least five years. Part 2: Rehabilitation after total laryngectomy For rehabilitation after TL, there are numerous possibilities for improvement, but each comes with its own challenges, such as costs. Additionally, investigating all these interventions is difficult due to the low number of patients.
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