You Must Decide!
Wed, August 24, 2005 at 05:12PM When I was young, the doctor would tell my mother: “He needs his tonsils out; I’ll arrange it for next week”. And that was that – no questions or arguments, because what the doctor said was the last word. Twenty years later, in medical school, we were taught: “Tell the patient what needs to be done, and ask if they have any questions; they probably won’t have any”.
Today, things are different. If you have an enlarged prostate, the doctor will lay out the options – drugs, supplements, or surgery (with several different approaches). If he has time, he’ll give you the pros and cons for each approach. But in the end, he’ll say: “You must decide”. It must be accepted that the reason for this is partially due to the fear of litigation – the doctor might be sued for suggesting a treatment that goes wrong.
Well, patients are deciding. But do they always reach the best possible answer? A recent survey of women with breast cancer choosing total mastectomy or more limited local tumor removal (‘lumpectomy’) found that, when the women chose alone, 27% chose mastectomy. If the surgeon made the decision, only 5.3% had a mastectomy, and where the patient and the surgeon shared the decision, 16.8% had a mastectomy. In other words, many women chose an option that was more ‘radical’ than their surgeons felt was necessary.
Who knows best, in this age of ‘the informed patient’? We don’t know. But sites like HealthandAge.com and the ones we list in our 'Links' page do their best to inform people on health matters, so that they are able to cope better when the doctor says “You must decide”. And don’t forget – if you have any doubts at all, you can (and should) ask for a second opinion. (But maybe not a third, fourth, or fifth opinion.)
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