Wednesday, April 7, 2010

Just say 'no' to excessive medical care

Posted By on Wed, Apr 7, 2010 at 10:09 AM

No, really. Just say no when your doctor suggests the most expensive prescription in his or her arsenal ... the one you already tried that didn't work so great. Just say no when they want to run one more test ... the one you think is unnecessary. Just say no to that little extra thing they say they're doing as a favor ... that thing that shows up on your bill later with more zeros than necessary.

For whatever reason, we — and I'm no exception — have a difficult time saying 'no' to doctors. However, in order to bring the cost of health care down we have to work together and we have to work smart.

Instead of nodding in agreement every time your doctor suggests a test, pill or procedure, educate yourself and make the choice that's best for you instead of following along with the doctor's wallet padding inclinations. There are plenty of resources at the library and on the Internet to help you help yourself. When in doubt, you can always ask a librarian to point you in the right direction — they are exceptional aides when it comes to research.

Here's more on the power of no from The New York Times:

Deep down, Americans tend to believe that more care is better care. We recoil from efforts to restrict care.

Managed care became loathed in the 1990s. The recent recommendation to reduce breast cancer screening set off a firestorm. On a personal level, anyone who has made a decision about his or her own care knows the nagging worry that comes from not choosing the most aggressive treatment.

This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans.

From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.

So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”

It’s not just CT scans. Caesarean births have become more common, with little benefit to babies and significant burden to mothers. Men who would never have died from prostate cancer have been treated for it and left incontinent or impotent. Cardiac stenting and bypasses, with all their side effects, have become popular partly because people believe they reduce heart attacks. For many patients, the evidence suggests, that’s not true.

Read the rest of this article, by David Leonhardt, here.

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