Shared decision-making (SDM) is a process where clinicians and patients communicate and share evidence, giving patients an informed, active role in healthcare decisions.1 This paper addresses SDM in a local setting in the kingdom of Bahrain. Participants filled a questionnaire with two decisional-role outcome measures. Dependent variables were patient role preference pre- and post-consultation. McNamar-Bowker’s test was used to assess deviations in patient preferences pre- and post-consultation. A total (n=566) filled the questionnaire; 2.3% (95% CI; 1.2 - 3.9) preferred an active role while the majority preferred a collaborative role (43%, 95% CI; 39.0- 47.2) before their encounter with the doctor. Post-consultation, 7% of the participants had a less active role, and 31% a less collaborative role in comparison with their preference, whereas the passive role increased from 49% to 62.0% in relation to expressed preferences. It is apparent that the results lack symmetry (McNemar-Bowker S=38.5; DF=3; P= 0.001). Patients aged 36-49 years are less “collaborative” (33.1%) and more “passive” (57.5%) than younger and older age groups (p < 0.028). Higher educational meant more preference for the collaborative or active role (p < 0.01). Primary healthcare attendees prefer a passive role in SDM. Nevertheless, healthcare providers should not assume patient passivity in SDM, but must assess and treat each patient individually