From Power Imbalance to Partnership — Dartmouth’s Dr. Glyn Elwyn: Meaning & Purpose in the Exam Room
World leader in shared decision‑making Dr. Glyn Elwyn (Dartmouth) joins Judson to unpack co‑production in healthcare: what it looks like in real visits, why simple tools like Option Grid change choices, and how SDM can protect clinicians from burnout and moral injury while improving outcomes and patient trust. Glyn traces his path from rural Wales—through a lab explosion, an arts degree, and a “back‑door” into medicine—to building the field’s most used measures (Observer OPTION‑5, CollaboRATE) and pushing health systems to become true learning health systems. We also explore ambient listening, elective surgery utilization, primary‑care access, and what leaders (and payers) can do tomorrow.
Episode Summary
Every physician believes they involve their patients in decisions. The research says they're wrong. Dr. Glyn Elwyn has spent 30 years measuring the gap between what clinicians think they do and what patients actually experience — and the gap is vast. In this conversation, he explains why shared decision-making is so difficult to sustain, what tools like Option Grids do that conversation alone cannot, and how the rise of ambient AI listening in exam rooms could either amplify or destroy the patient-clinician relationship. He also speaks candidly about burnout, moral injury, and why the best protection against both is restoring meaning to the clinical encounter.
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About the Guest
Dr. Glyn Elwyn
Professor, The Dartmouth Institute · World Leader in Shared Decision Making
Dr. Glyn Elwyn is a professor at The Dartmouth Institute and the world's foremost researcher on shared decision-making (SDM) in clinical practice. Born in rural Wales, he took an unconventional path through arts and emergency medicine before dedicating his career to ensuring patients have a genuine voice in their own care. He created the Option Grid decision aids and the Observer OPTION-5 and CollaboRATE measurement tools — now used globally to evaluate how well clinicians partner with patients. He has published over 400 peer-reviewed articles and remains a leading voice on how technology can enable — or undermine — true co-production in healthcare.