Discussing Prognosis and Shared Decision-Making.

When making high-stakes decisions with their patients, surgeons may have only one opportunity to get a life-changing conversation right. These loaded conversations cover immense ground. Bad news, emotion, prognosis, treatment choices, and patient goals all play a part in coming up with the right plan for each individual patient. Surgeons and patients may overlook important factors when the language and process of informed consent is substituted for decision-making. "Best Case/Worst Case" is a communication tool based in scenario planning that promotes shared decision-making in high-stakes surgical conversations and is discussed at length in this review.