Patients with plaque psoriasis now have an array of treatments to choose from. These have shown to be efficacious in randomized controlled trials, in which, generally, the benefits outweigh the harms in more patients in the treatment arm than those receiving a placebo. However, the decision is not clear for individual patients because it is “preference sensitive,” where the right balance of benefits and harms depends, in great measure, on the weight or value that a person gives to the benefits and harms.1 In this context, shared decision making between the patient and the practitioner is essential in reaching the best decision, one that patients feel satisfied with and supports physician-patient communication. It is imperative that shared decision making be given priority, especially in light of the almost universal adoption of evidence-based medicine, the success of the Cochrane Library, and the Grades of Recommendation Assessment, Development and Evaluation (GRADE) approach to evidence-based guidelines.