Background: In China, an estimated number of over 90% of patients would like to participate in shared decision making, especially when medical costs for health care falls on their shoulders. There has been a discussion of the attitude to patient involvement in clinical decision making, and its importance has been recognized. Objectives: To investigate the attitudes of clinical doctors towards the difficulties in patients involvement in clinical decision making and to analyze the factors that affect patient involvement. Methods: We developed a questionnaire with 10 questions. 273 questionnaires were distributed at random to the clinical doctors in West China Hospital, Sichuan University. Statistical software such as SPASS and MS Excel was applied to analyze the data. Results: A total number of 273 clinical doctors returned the questionnaires of which 259 had completed it (179 in-patient doctors, 80 outpatient doctors). The difficulties which the doctors were most concerned about focused on ten aspects: lack of time (69.50% in-patient doctors, 85.39% out-patient doctors); application of evidence to patient (77.14% in-patient doctors, 73.29% out-patient doctors); providing the best evidence (52.75% in-patient doctors, 65.53% out-patient doctors); providing the best treatment for patients (42.50% in-patient doctors, 63.07% out-patient doctors); communicating with patients (35.00% inpatient doctors, 45.46% out-patient doctors); diagnosing the disease (43.04% in-patient doctors, 67.23% out-patient doctors); eliciting the patients’ values (51.90% in-patient doctors, 55.36% out-patient doctors); knowing the dangers of the treatments (51.25% in-patient doctors, 50.84% out-patient doctors); establishing stable alliances and relationships with patients (51.25% in-patient doctors, 60.45% out-patient doctors); cooperating with patients (55.00% in-patient doctors, 64.41% out-patient doctors). In most aspects, the in-patient and the out-patient doctors had the same attitude except in three aspects: satisfying the anticipations of patients; communicating with patients to understand their anticipations; and communicating to diagnose the disease correctly. Conclusions: From this study, we learned that doctors still have some difficulties in patient involvement. So some strategies should be developed.