It was Shakespeare’s Hamlet who wondered “To be, or not to be”; but in health care, the question is altogether different: It’s “Should I, or shouldn’t I?”
That’s because as our diagnostics, treatments, surgeries and medications have gotten more and more sophisticated, potential benefits and risks are nuanced and vary depending on your own preferences, issues, comfort level and goals.
You can learn how to make better healthcare decision in the same way you get better at other areas of planning and decision making in your life, including financial management, buying a car or a major appliance, or even traveling.
For some, this new reality is going to be frustrating because it would be so much easier to just be able to lean back and ask for absolute direction. Some people are still doing that, by the way, with mixed results. But the truth is, what works for your friend or your physician may not be the best choice for you. When given clear, understandable information and data on relative risk factors, people tend to weigh the options differently than do their physicians.
Who has the time or the insight to read and understand all the information that’s available to us all? None of us do, honestly — not even most physicians, to be frank.
Here’s an example. I have a friend (who happens to be a scientist); she was put on a statin (one of the most commonly prescribed drugs in the world, used to lower cholesterol, a factor that may lead to heart attack and stroke). After several months on the drug, she thought she wasn’t as strong as she had been, and talked to her doctor, who changed her statin to a different medication. She still felt less strong. So she did some reading, evaluated her risk factors for cardiovascular disease, and stopped taking the prescription. (I believe she informed her physician of her decision, by the way). She feels great now, and she’s exercising more than ever before (which will undoubtedly reduce her risk for cardiac disease significantly).
Check out “Your Medical Mind: How to Decide What is Right for You,” by Jerome Groopman and Pamela Hartzband, both on the faculty at Harvard Medical School. They discuss issues like my friend’s question about her statin and provide guidance about how you can responsibly become a smarter patient and understand the influences that sway decisions — both your healthcare provider’s and yours — about health care.
Also worth reading is Thomas Goetz’s “The Decision Tree,” which describes how people who engage in their healthcare decision making achieve better outcomes. He talks about why some screening tests are a better bet than are others and explains the difference between smart screening (early detection that saves lives) and dumb screening (overuses technology and often causes anxiety and unnecessary interventions).
These books may help you feel more capable of asking the right questions about the relative risks and benefits of everything from an annual mammogram or PSA test to the merits of back surgery versus medication and physical therapy.
The next time you visit a healthcare provider, practice these skills and test your ability to ask the right questions and evaluate your own preferences. It’s worth it; the chances are you’ll get better outcomes.