One of the things about being sick is that you are vulnerable. Anyone, (yes-anyone- I see too many neighbor-marketed health solutions) who has anything to offer you seem plausible. But add a white coat and a big, shiny medical building, and we’re all buying. And buying. But what we’re getting may not give us anything of value. In Atul Gawande’s New Yorker article he says bluntly: “Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm.”
When we ask doctors to decide which procedures to do, they will always err on the side of too much. Doctors remember their mistakes, not the unnecessary testing they’ve done. One missed diagnosis haunts a doctor for decades, leading to untold thousands of unnecessary, “just-in-case” tests.
But every procedure, (yes-every procedure) has risks. So unnecessary can become fatal. Everyone has those horror stories, of the testing procedure or minor surgery that went terribly awry. What no one remembers is the much more common uncomfortable, painful, and lingering side effects from a mildly botched test: the massive bruise from a poor blood draw, the discomfort from a laparoscopy scar, the pain associated with most medical procedures that are supposed to make you feel better.
What can a patient do? Unfortunately, we need to educate ourselves. You don’t need a medical degree, you need to find someone with one. Have them do a little basic research. I answer questions on Quora, an online question site frequented by numerous doctors. Or venture forth yourself. Ask your doctor for the most “up to date” research (which is a company who compiles research for doctors), get a medical dictionary and reading glasses, and slog through it. You’ll have questions, and getting those answers is the definition of informed consent.
Those feeling braver can venture onto pubmed themselves. Type your condition and the word “Cochrane” to get a listing of the reviews of all the studies regarding your condition. Print them out and write down your questions. If possible, send your questions ahead of you before the next appointment. When in doubt, get a second opinion from another, non-affiliated doctor. Sometimes one doctor will recommend something and another will recommend against it. Make up your own mind and remember that you can never ask a doctor to tell you not to get a test or procedure done. That’s a decision he or she can’t make without medical liability if something happens to you.. You can ask if they would have the procedure done themselves, given your circumstances. That might give you a more truthful answer. In the end, it is your healthcare.