This study assessed shared decision-making among thousands of surgeons, revealing critical insights for improving patient outcomes.

• Only 1.2% of surgeons achieved top scores in shared decision-making, while 64% of patients felt their surgeons performed adequately.
• Male surgeons, those in cardiothoracic specialties, and surgeons with over 31 years of practice were linked to lower decision-making scores.

Surgeons should consider these factors for enhancing patient engagement and aligning treatments with patient values.

• Performance could improve through targeted training initiatives based on individual surgeon assessments.