1. Health

Taking Responsibility for Your Own Medical Treatment Decisions

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Updated September 06, 2013

When we are sick or hurt and life is more focused on not feeling well, or being in pain, it's very tempting to default to letting others make our decisions for us.

When those others are people who love us, like a spouse or parent, or people we trust like an advocate we've hired, then defaulting to their opinions or suggestions might work well, as long as they have considered the pros and cons, working their way through the decision-making process.

But notice who was not included in that list of people you should default to. There is no mention of your doctor, or any other healthcare professional.

That is not to say that your doctor is not trustworthy and shouldn't be included -- not at all. In fact, your doctor is absolutely your first resource, your front line for advice giving and helping you look at all sides of your options.

But advice giving and decision making are two different things. Defaulting to your doctor's advice without looking into it further is like asking your doctor to make your decisions for you. And that's not an empowered patient approach.

Advice vs. Decision Making

Would you ask your auto mechanic to decide whether you should replace your engine or buy a new car? Probably not. You might ask him all the questions that will help you make the decision yourself, and his input will be valuable. But you are the one who will make the ultimate decision.

However, that raises another question. Just how objective do you think the auto mechanic will be? If you decide to replace your engine, he'll make a nice profit from doing that work for you. But if you decide to buy a new car? Not only will he not make a profit on the work, but your new car may be under warranty, meaning, he won't see anymore business from you until your warranty runs out. So which advice do you think he'll be more likely to give?

Further, your mechanic doesn't know what your personal plans are preferences are. He doesn't realize that you've promised your son he can drive that specific car when he turns 16, or that it belonged to your grandmother and it brings back great memories when you drive it. He doesn't understand your values in relation to that car.

Nor does your doctor understand your values in relation to your healthcare. Your doctor's job is to keep you alive as long as possible. That might be in conflict with your preference to live a better quality life for less time.

What Influences a Doctor's Advice?

Once your diagnosis has been determined, your doctor will consider options for your treatment. As part of that process, your doctor will share the one she thinks will work best for you. As a wise patient, you will discuss those options, and then spend some time researching the possibilities, including options your doctor may not have recommended.

A wise patient understands that, similar to the auto mechanic, sometimes our doctors' decisions may be influenced by business, not just medicine. This is not to suggest a doctor would recommend a treatment he didn't think would work; rather, when two or more treatments will have a similar rate of success, the doctor may make a recommendation that is better for his business, and not necessarily better for his patient.

Consider Ted's decision making. Ted was diagnosed with prostate cancer and was told he needed surgery. His urologist recommended a minimally-invasive laporoscopic procedure which uses tiny incisions, explained its unpleasant side effects, and gave Ted some time to think about it.

Ted wisely took that time to learn about his options, and during his research, learned that a robotic prostate surgical technique had been developed which would eliminate or lessen some of the difficult side effects. Excited, Ted returned to his urologist to learn more about the robotic surgery. The urologist told him the robotic surgery wasn't all it was cracked up to be.

Based on his research, Ted didn't think that made sense. Ted asked the urologist how many of his other patients had undergone the robotic surgery. The answer was none, because that urologist didn't do robotic surgery.

Ted realized that the only way he could get objective advice was to find a doctor who could perform both kinds of surgery, because that doctor would profit no matter which choice Ted made.

He did so, ultimately changed surgeons and moved forward with the robotic surgery since it seemed to him to be his best choice. He did learn later, however, that some questions had been raised about just how much better the robotic surgery might really be - but he still felt that for him, it was the best choice.

What Can You Learn from Ted?

When it comes to taking responsibility for making your own medical decisions, then it's important for you to listen to your doctor. She has the education, the experience, and the skills needed to make good recommendations, and she will be able to answer the questions you have about her recommendations.

But objectivity is very important. You need to do your research, too, to find out about all the options available, then find the professional you think can give you the most objective advice.

Further - your own preferences, based on your values and beliefs should influence your decisions, too. A process called Shared Decision Making might be just the ticket for helping you make your treatment decisions.

Once you have all the possibilities to choose from, it's time to make the decision that works best for you and your goals, knowing that you are making the most objective decision possible for your situation. And once you've made that decision and begun the treatment, it's up to you to follow it through to find your best outcome.

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