Ask Your Doctor Four Questions About Any Treatment
Your doctor recommends something, and you do it. This is the simplest version of how the relationship between doctor and patient can develop, but not always the best. You may find out later that there were other treatment options that you never knew about, or that a medicine you are taking has risks that may outweigh the benefits. To get the full picture, ask these four questions.
What are the chances that this will help me?
It’s very simple: if a healthcare professional recommends something, he thinks it can help. But how likely is it that it will actually help?
John Mandrola, an electrophysiologist cardiologist who wrote about the four questions, notes that there are two components to the question: statistics about the benefits of a treatment (or, if we are talking about a test, its accuracy) and how you and your doctor determine the benefits. … For example, lowering your cholesterol does not always reduce your risk of dying from a heart attack. So be sure to ask about the real benefits.
What are the chances it will hurt me?
Everything has risks, even treatments or tests that seem pretty straightforward. The only medications that don’t have the risk of side effects are those that don’t work . Even tests can be harmful in the long run if they lead to interventions, such as drugs or surgery, that are unnecessary.
However, risks and harms cannot always be separated from benefits. Chemotherapy for cancer is extremely harmful to the patient, but it must be weighed against the benefit of not dying of cancer. Think of the risks and disadvantages as the “cost” of the drug (and, yes, financial costs can also be included). Is it worth it?
What are the alternatives?
Sometimes there is only one real option, and if you ask about alternatives, your doctor can explain why other treatments are not appropriate. But sometimes other alternatives can be considered.
If you don’t ask your doctor, after a few years, you may find out that your aunt / friend / colleague had a similar health problem and that they were treated differently. Maybe your doctor has recommended a really better treatment; on the other hand, maybe they recommended an operation that they personally are really good at, or a drug that most patients prefer. It’s always worth asking what other options are available.
What if we don’t do anything?
Doing nothing is also an option with potential harm and benefit. Your doctor will often try to solve the problem in order to suggest the best possible remedy for the problem you are seeing. But sometimes doing nothing is also a good option.
Often times, inaction takes the form of “watchful waiting” – watching to see if your condition becomes serious, instead of treating it today just because you are in the office today. Or perhaps the treatment just doesn’t have much of a chance of benefit and you can skip it and most likely get the same result anyway.
If your doctor recommends taking a test, this question becomes especially interesting: What would we do differently with the test results than without them? Sometimes the treatment is the same anyway and the test is not needed at all.
These four questions help because they guide the conversation. Your doctor must understand which benefits and harms are most important to you; you will understand why your doctor recommends some treatments and not others.
This is a good and important conversation, and there is nothing wrong or wrong with understanding your treatment and having a say in decisions. After all, this is your body and you will live with the consequences. Doctors and other healthcare professionals are usually happy to answer questions, and if your doctor doesn’t like you asking questions, he’s a jerk and you should find a new doctor.
I have found that doctors often do welcome these questions. If there is a clear benefit that outweighs the risks, they can simply explain it, and I agree: let’s do it! But other times I ask about a test and they say, “Oh, the computer always adds this to the order. We really don’t need it. ” You won’t know until you ask.