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Everything you need, but nothing you don’t need

The goal of good healthcare is to make sure you get everything you need, but nothing you don’t need.  Anything you don’t need is only a risk.

We all know that the costs of healthcare are skyrocketing.  Most people think that the drivers for the increasing costs are the expensive technologies and pharmaceuticals that provide nearly miraculous improvements in the treatment of common severe diseases like cardiovascular disease, cancer, and kidney failure.  However, another major cause of the rising costs of healthcare lies in the overuse of less expensive testing and treatments that have no proven benefits.

Despite the attraction of many traditional or “cutting edge” weakly tested medications or treatment plans, they not only cost a lot of money, they also cause a lot of harm.  The best way to be sure you don’t fall prey to overtesting and overtreatment is to be sure you and your doctor have fully explored the benefits, risks, alternatives, and unknowns of any test or treatment plan.

Get any test or treatment that you need to make a diagnosis or treat its consequences.  But avoid any test or treatment that you don’t need; it is only a risk without any benefit.

The art of medicine is knowing how to analyze and balance benefits, risks, alternatives, and unknowns.  I have done that with all of my patients for my entire career, and I still find it challenging.  It starts with listening carefully to a person’s goals and values and then listening carefully to their story.  Next, I try to match the true evidence supporting any tests or treatments being considered with the individual story, goals, and values.

If you would like to take charge of your own healthcare by being sure you’re getting everything you need, but nothing you don’t need, we can help.

Know the culture that drives medical decisions

This essay reveals the shared social imagination the fuels a dangerous and expensive healthcare culture.

Due to the influence of pharma fueled academic experts, doctors too readily prescribe marginally effective medications with many unanswered long term safety questions.

Learn to question all medical decisions your doctor makes by asking about the risks, benefits, alternatives and unknowns involved. If your doctor can’t answer those questions in detail for you, be wary.

We can help you ask the right questions so you can collaborate with your doctor to make good medical decisions and get the best care.

https://www.statnews.com/2017/12/27/pharma-advertising-trends-2018/

If you have high blood pressure it’s critical to collaborate with your doctor when treating it.

While SPRINT produced some interesting data on how best to treat high blood pressure, the flaws in the study, and the high rate of adverse events like syncope and acute kidney injury mean that wise physicians must exert great caution in the implementation of more aggressive BP targets.

This science is far from complete. In the setting of such medical uncertainty, only collaboratively shared decisions with a full explanation of the risks, benefits, alternatives and unknowns should be the standard of practice.

Take charge of your health and healthcare, and collaborate with your doctors to make shared decisions.  We can help you to collaborate with information and coaching.

New SPRINT trial data raises more questions.

Another reason to take charge of your health and healthcare: FDA approval still leaves many unknowns

It is critical to understand the risks, benefits, alternatives and UNKNOWNS of all your medical decisions.  Many new medications have a lot of unknowns regarding their efficacy and safety, and those unknowns must be considered when deciding to prescribe them.  If your doctor doesn’t have time to discuss the full thinking behind a decision to use a new medication and allow you to share in that decision, we can help.

Drug safety issues often arise after FDA approval, a new study finds Does it mean drugs should undergo more rigorous pre-approval testing? Not necessarily, one expert says CBSNEWS.COM

How discussing risks, benefits, alternatives and unknowns can make a difference for you

Your doctors should be listening to you, understanding your goals and values, and explaining the risks, benefits, alternatives, and unknowns of your care.

If your doctor does not fully discuss those with you, then you can’t make choices that fit your own goals and values.

Jan Vick Harris courageously published an account of what happened to her after a mammogram picked up a ductal carcinoma in situ, and she went forward with treatment decisions that she did not fully understand.  The account illustrates the critical importance of this process of care.  A link to the article is included below.

After reading her story, imagine if she could have had a discussion with her doctor before she had her mammogram. She would have been better prepared for dealing with the ensuing course of action that became confusing, unsatisfying and potentially harmful to her.

She needed that discussion, and her doctor listening to her thoughts, both before the mammogram, and before embarking on the uncertain course of treatment that her doctors prescribed.

If your doctors are not thoroughly discussing risks, benefits alternatives and unknowns with you, or they’re not listening carefully to your views on them, contact Operam Healthcare for a no cost consultation on how we can help.

 

 

You can read Jan Vick Harris story here