Monday, October 14, 2013

Making your own medical decisions

The newest trend in medical care is to involve the patient in the decision making process. Sometimes it can be easy to just go with the flow. The doctor says you have this so we need to do that. Simple?

But what if the doctor says 'what do you want me to do for treatment?' Eek! Now you can't sit there passively you have to become a participant. This can take research. It can take time online. It can take deep thought. And it can impact your life significantly.

Using the example of a woman with breast cancer where the choices with relatively equal outcomes are lumpectomy and radiation or mastectomy. Shouldn't the patient get to decide, not the doctor on whether they want disfiguring surgery? Some women do and some don't. But it should be their choice.

The other side of the coin is patients go to the doctor for a sore throat and expect to be sent home with a prescription for antibiotics. And the doctor says we do not prescribe antibiotics for a cold or flu only when there is a need. The patient then gets mad because they feel under treated. This is the result of a change in medical practice that patient's need to keep up on to prevent frustrations.

Let's go back to a cancer diagnosis. The doctors say things like we want to remove the tumor and then do chemotherapy and follow up every three months with a scan. The patient should ask why that order - surgery then chemo, what are the alternatives, what about the patient's other health issues and possibly even age.

The real question the patient should ask is what are my options for the best possible prognosis and why do you consider that to be the best as compared to other protocols? I mean that is the goal after all.

Doctors need to allow patients to ask questions and make the decisions based on the doctors advice. If the doctor doesn't want the patient's input, it may very well be time for a new doctor.


Patients need to learn to set aside their preconceptions on what they think is possible and learn what are the latest advances and what has the best possible outcomes. Then they can, with the help of their doctor, make the best possible decisions about their health.

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