Choosing Wisely

Making the right health choices can be tricky. There is so much information available and it is difficult to know what information is good. I'll never forget when I was a new doctor and I had a discussion with my mother about some health topic that we disagreed on. She told me that she had proof that her point of view was right and I was wrong. I asked to see it and she showed me a stack of articles she had printed from various websites, most of which were selling something. Given my training I was looking for something more along the lines of studies from peer-reviewed journals. People have different criteria for choosing who's information to trust. 

For example Dr. Mehmet Oz has a huge following of people who think he is a medical genius. He is charismatic and friends with Oprah but trust me… he's no genius. See?  I said it: Trust me. Why should you trust me more than a guy with a TV show and famous friends? Well for one I get paid by my patients for helping them get healthy and he gets paid by advertisers. This is why he says things like organic foods are for "snobs" and frozen vegetables have the same nutritional value as fresh vegetables. In fact you'd be better off listening to almost nothing he has to say about nutrition.  But I digress… My disdain for Dr. Oz is for another post. 

We need to come to grips with the fact that our health care system isn't exactly healthy. We use many antiquated concepts based on a model where Doctor-is-God, making decisions for us that we are expected to blindly follow. We are in denial about how bad our system is for us. We have very high hopes for medicine but very low standards. We thoughtlessly swallow pills that kill 100,000+ every year (even when "properly" prescribed). We are led to tens of thousands of unnecessary procedures each year which result in avoidable death and permanent disability. The problem is not the doctors. Many doctors feel trapped in their own profession. They read the studies, see the results and experience the tragedy but they are controlled by their mega-hospital, managed care organization or other entities that tell them what to do, for whom and when/how often.

What can you do about it? You can start by taking responsibility for your own care. You don't need to subject yourself to every test and procedure and swallow every pill. I'm not saying that you should not comply with a good treatment plan. I'm saying that you should understand and feel confident that a porposed treatment plan is a good one.v If it doesn't make sense or the risks seem to outweigh the benefits then be courageous (AKA smart) don't do it!  Ask questions. If your questions seem to annoy your doctor then it's time for a new doctor. 

I found a great resource that I'm going to start recommending to all of my patients. I think it will help them make better decisions about some of the most common unnecessary tests and procedures in a variety of health disciplines. It's produced by the ABIM foundation and it is called "Choosing Wisely". The idea is to get doctors and patients communicating better and avoiding unnecessary procedures. Click this link to get information on questions like when you need a chest X-Ray, antibiotics, a pap smear, or how to manage GERD. This is honest information, based on evidence from organizations like the American Academy of Family Physicians, the American Society of Clinical Oncology, and American Academy of Asthma, Allergy and Immunology. 

At the end of the day your doctor's main job is not to heal you. That's your responsibility. Doctors provide some technical skills such as manipulation, procedures and diagnostics. The doctor's main responsibility is to help guide you to the right interventions to ensure your overall health and well-being. Notice I didn't say, "Make the decisions for you". Doctors are your guides but you are the decision maker.  Choose wisely!

This Post Has 3 Comments

  1. Robin

    I had an experience just recently where I had to question what the doctor prescribed me. I had a situation that sent me to urgent care and I needed antibiotics (yuck) I was extremely clear that I am a nursing mom and I had to have something that I could still nurse while taking. He gave me a prescription and I asked him if I could nurse while on it. He told me “I don’t know”, he didn’t even care. So I had to ask the pharmacy and it turned out that the antibiotic is absolutely not supposed to be given to anyone under 18 and does show up in breast milk, is toxic to the baby, etc. I understand he is an urgent care doctor and very busy, but my word, what if I hadn’t thought to ask?! Even better was that the antibiotic I was on didn’t work and I had to get a new one, This time I had a doctor with time and who did the research and helped me find the research so that I could discover for myself that it was safe.

  2. Jason Young, DC

    Yeah that’s just outrageous and it’s unfair.  People deserve better than to be treated like that.  I have started to take the medication lists for my new patients and entering them on Drugs.com.  They have a simple interface for looking up drug interactions.  I enter all of their meds and print that out.  I circle interactions and side effects that match some of their symptoms and give the print out to the patient with the instructions to take that to their prescribing doctors and come up with a better plan.  

    CATCHING THESE THINGS IS SOOOOOO EASY.  If you’re doctor won’t do it for you then you have to do it for yourself (or your child).

  3. Melissa

    As I was reading this post and got to the end the last paragraph hit me hard. When you said “your doctor’s main job is not to heal you. That’s your responsibility.” My thoughts were no wonder my chiropractor has been telling some of the things they have. I know they have helped me and I so appreciate everything. I feel like I’m having some set backs right now and know exactly sure what to do, but will grin and bear it. 🙂
    Is there a website that you put the medication in. I’m on some supplements that another doctor gave me and feel in a way they are working but would like to know if there is a toxin in them. (I don’t think this doctor would prescribe them if there was but I’m curious.) Thanks for your post!

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