Shared decision making is an interactive and collaborative process between patients and health care providers that is used to establish and execute health care decisions. This process is characterized by several features of the patient-provider interaction including eliciting and acknowledging patients’ preferences for participation; providing choices as to how the decision-making process will proceed; and mutually respecting and adhering to the ultimate choices established by patients. Shared decision making takes place based on the premise that patients have a right of self-determination. An expectation also exists that patient involvement in shared decision-making can increase the likelihood of treatment adherence by patients, improved health care outcomes, and decreased health care expenditures. This notwithstanding, the altruistic and beneficial practice of shared decision making is potentially fraught with challenges including a perceived excessive time commitment to the process with incomplete adherence by providers. In addition, contextualizing this process can represent a challenging task for providers. Finally, the touted benefits of shared decision making, including patient satisfaction with decision (SWD), improved patient outcomes, and decreased health care expenditures must be scientifically scrutinized to justify the best practices designation and widespread implementation of SDM.