This article hypothesizes that while the principles of evidence-based practice should serve as a guiding ideal for physicians, the manner in which this practice style is commonly implemented may be insufficient to the provision of truly informed decision-making and consent - especially in cases where outcomes are inextricably tied to technique, such as in the surgical subspecialities. Specifically, current methods of 'shared decision making' fail to adequately incorporate patient-specific expectations and physician-specific outcomes. A 'next-step', aimed at matching such expectations with outcomes is suggested and a method for implementation is presented.
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