Shared Decision Making (SDM) is essential for patient-centered care. While global adoption is increasing, implementation in Korean primary care remains limited.To review global SDM policies and analyze the feasibility of their application in Korea, focusing on the role of family medicine specialists.We conducted a narrative review of academic literature and policy documents regarding SDM implementation in the US, UK, Germany, and Canada. We analyzed key success factors from these countries and evaluated their applicability to the Korean context, specifically examining legal frameworks (e.g., Medical Service Act) and the primary care environment.The review identified that successful SDM implementation requires institutional support. In Korea, barriers include the lack of reimbursement and standardized tools. Based on the comparative analysis, we derived three strategies: 1) Developing Korean-specific models (e.g., adapted Three Talk Model) and Patient Decision Aids (PDAs). 2) Policy reform to introduce an "SDM Counseling Fee" within the National Health Insurance. 3) Mandating SDM training in family medicine residency programs.Current literature suggests that individual physician effort is insufficient for SDM sustainability. Family medicine specialists are ideal leaders for SDM, but structural changes identified in international cases—specifically reimbursement and education—are prerequisites for success in Korea.Implementing SDM in Korea is feasible if supported by a multi-faceted approach involving tool development, policy reform, and education, aligning with global trends in patient-centered care.