The aim of most patient-clinician consultations is to improve health outcomes. Most often they succeed, and patients are to a greater or lesser extent satisfied and empowered. However, some consultations are unsatisfactory and result in failure to improve health outcomes; dissatisfaction on the part of patients, carers or clinicians; complaints and litigation; and even unnecessary morbidity or mortality.

In our experience, when consultations fail to achieve the desired results, the cause is not usually a failure of evidence-based practice. Today's clinicians are trained in evidence-based medicine, educated, updated and appraised to a point where they can find most of the accurate scientific information they need to assist patients in decision-making. The most likely reason why things go wrong is a failure of values-based practice – not ascertaining the relevant values perspectives and acting on them in a coherent and purposeful manner, evolving individual patient-centered decisions that are informed by values as well as evidence.

This book aims to help clinicians acquire and develop the processes of values-based practice that support evidence-based practice in the particular situations facing individual patients.