Hartzband: In the book we talked about the case of someone with an overactive thyroid. The first doctor says, “This is the best treatment.” But it turned out that this patient found it to be a huge burden to have to take a thyroid pill every day forever [following radioactive treatment to destroy the thyroid gland]. As doctors, we think it’s no big deal when we prescribe pills all the time. This doctor projected his point of view and almost couldn’t see another point of view.
Groopman: It really is a partnership: We don’t want to be presumptuous and project our own opinions, nor should a doctor say, “I don’t know; you decide.”
Should doctors always follow the patient’s lead?
Hartzband: Although you may be a minimalist and a doubter, that doesn’t mean [that less treatment] is the right decision for you. A doctor can help explain that.
Groopman: Being a believer and maximalist, I wish I’d understood that mind-set with my back. [Groopman had unsuccessful back surgery about 30 years ago.] I had very bad back pain. I wish a doctor had said, “You want to believe that there’s an answer to this and that there’s a technology solution. But . . . there’s a lot about back pain that we don’t understand.”
Hartzband: Whether he would have listened is another matter.
Groopman: At least it would have tempered it.
To what extent should people allow others’ medical experiences to influence their own treatment decisions?
Hartzband: The input of medical information from friends and family is part of what shapes your medical mind from a young age. But sometimes it’s helpful and sometimes it’s not helpful. The way it’s not helpful: When you hear a story — [say,] a relative of yours had a bad side effect from a medication — it’s going to be hard to get it out of your mind. Our minds are structured so that stories have a huge impact. The problem is that something that is quite rare can seem like it’s very likely to happen to you. In our book, Susan Powell goes to church and sees someone who has very bad muscle pain from taking a statin. But the actual numbers show somewhere between 1 and 10 percent of people will get that side effect.
How can people avoid regretting medical decisions?
Hartzband: In our book, we talked about two people who had orthopedic surgery. Both had bad outcomes and were worse after surgery. One was disappointed but had no regret. The other felt very bitter and regretted that she’d gone ahead with the surgery.
We found that one person had followed his own process of medical decision-making and knew his medical mind. The other person felt she’d been pushed [by her doctor] and led to do something she wouldn’t normally do, and felt bad about that. She regretted taking an approach that was not only disappointing but not consistent with her own [minimalist and naturalist] philosophy.
Groopman: There’s often a lot of self-blame. I can speak from personal experience. I profoundly regret having back surgery. I didn’t go through a good process. We can’t erase uncertainty, but we can have much more confidence we’re making the right decision and understand how our mind-set can lead us astray.
This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente. E-mail questions@kaiserhealthnews.org.
The Post Most: NationMost-viewed stories, videos and galleries int he past two hours
Featured Reads
Loading...
Comments