Sites Help Patients Facing Difficult Choices Make Better Decisions

Every day millions of patients make weighty decisions about their health, usually they rely heavily, if not entirely, on their doctor’s opinions. But do the doctor’s give out enough information so the patients can form useful opinions themselves? And do doctors listen to the patients about their preferences? Doctor and patient.

Recent research suggests many don’t, as this excellent article by Laura Landro in The Wall Street Journal points out. That’s leading to overuse of certain kinds of treatments.

“Studies show that when patients understand their choices and share in the decision-making process with their doctors, they tend to choose less-invasive and less-expensive treatments than they would have otherwise received,” Landro writes. The studies she’s referring to are coming out of The National Survey of Medical Decisions.

That means that many patients are having risky, expensive, and potentially harmful treatments that they could avoid. How can patients avoid this trap?

The Foundation for Informed Medical Decision Making was formed in part to address this problem. Here’s what they say: “A recent survey of patients conducted by the University of Michigan found that fewer than one in five was asked by their health care provider about their preferences for care… The survey also found that providers often neglected to tell patients about the potential disadvantages of treatments or tests that they recommended.”

WHERE TO GO FOR HELP
Breast cancer patients at UCSF can go to www.DecisionServices.ucsf.edu, to get links, information, services, and referrals to help them ask the right questions and make better decisions.
The director of that service, Jeff Belkora, also has a public website called www.guidesmith.org, where he offers tips on how to make tough medical decisions.
Patients whose doctor or employer have enrolled with HealthDialog can get a variety of decision support videos from that site. HealthDialog also offers three videos for free: They cover PSA testing, colorectal cancer screening, and surgical options for early stage breast cancer patients.
Patients can also request materials on a range of medical decisions directly from The Foundation for Informed Medical Decision Making by filling out this form. You can see the materials they have at the bottom of this page.
You can also ask your doctor if he or she has brochures that will help you better understand your options and advocacy groups (e.g. the American Heart Association) can also sometimes recommend useful materials.

This new concept of patients really understanding their conditions and their options is being called “participatory medicine” or “shared decision-making.” It’s based on the premise that no one knows your values, preferences, or lifestyle as well as you do. Therefore, only you can make the best decisions for yourself and you need to be fully informed to do that.