Does Your Doctor Always Know Best?
03 Oct 2015
Faced with a medical decision, patients normally allow their doctor to decide on treatment, assuming he or she “always knows best”. But “Consumer Report on Health” claims that this approach rarely works anymore. Doctors simply are unable to keep up with the flood of new information on medical therapy. Consequently, some medical decisions must consider the patient’s priorities, not just the doctor’s. This process might even decrease the cost of medical care.
Often the problem is communication. For instance, a study of 1,057 doctor/ patient visits, including 3,552 clinical decisions, found that only 9 percent provided the patient with enough information to make an informed choice!
So how do you figure out what is best for you? Potential traps are the now common operations of cataract surgery, and knee or hip replacement. Remember, these elective procedures should only be done when the physical condition affects your quality of life by inability to function. Not when the surgeon says, “I can fit you in.”
It’s also been reported that about one in seven women who have a hysterectomy don’t need the operation. So, ask if there are other procedures such as endometrial ablation that either remove fibroids or remove the lining of the uterus to decrease excessive bleeding.
Be cautious about long-term therapy such as the treatment of hypertension. Rather than submit yourself to a lifetime of prescription drugs, ask how lifestyle changes such as losing weight and exercise can be helpful. Taking a magnesium pill or a powder such as MagSense can relax arteries, decreasing blood pressure. So does the natural remedy Neo40 which, by increasing the production of nitric oxide, also relaxes arteries, thus decreasing hypertension. In addition, studies show that high doses of vitamin C and lysine will slowly remove atherosclerosis from arteries, a main cause of high blood pressure. Your Health Food Store will inform you of the various choices available.
Screening tests also cost our health care system billions of dollars annually. Some are of questionable benefit and may cause unintended complications. One study showed that 40 percent of checkups involved tests which were unproven. For instance, if you don’t have a family history of heart disease or coronary symptoms there’s no need for a stress test. Some authorities also believe the PSA test to diagnose prostate cancer should never to be done as it causes more complications than it saves lives. And women in their forties should discuss the pros and cons of mammography before agreeing to one.
Every year a large numbers of MRI’s are performed for low back pain. But they are not needed unless the procedure is required for a treatment decision. It’s well known that an MRI may show a disk problem, but it may not be the cause of the pain. Many patients have this abnormality without back pain. Besides, most back pain subsides without any treatment.
90 percent of hernias occur in men but how many require surgery? For years it’s been standard practice to operate to avoid bowel obstruction. But a study which followed several thousand men for several years discovered that, contrary to medical opinion, only one percent per year suffered from this complication.
Of course you must always ask your doctor, “What happens if I decide against treatment?” For instance, an 80 year old man with early prostate cancer may live another 15 years without treatment. In the interim he may die of something else. He may also decide that he does not want to take the risk of surgery and end up in diapers.
For women with early breast cancer a “lumpectomy” may be an option rather than complete removal of the breast. Some however, feel more assured if the entire breast is removed. The main point is to be an informed patient so there are no surprises.
Michael Barry, Professor of Medicine at the Harvard Medical School studied 2,600 adults age 40 and older who faced decisions about surgery, medicine and screening tests. He reports that their level of knowledge was low. Many did not even know why they were undergoing a specific procedure.
