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A Case For Why Patients Should Participate In Their Medical Care

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This article lists a variety of reasons to be active in your medical care. When read together, the points could lead you to think we're suggesting that you be on guard against your doctors. In reality, this is the opposite of what we believe.

We believe trust in your doctor is essential to your health care. That doesn't mean you can't disagree with your doctor. Or that you shouldn't seek a second, or even a third or fourth opinion when you think one is warranted. On the other hand, if you don't trust a particular doctor -- find another one.

Keep in mind that the vast majority of doctors care about their patients and do their best.

Reasons that people should be an active patient include (in no particular order):

  • Defensive medicine: With all the talk about malpractice litigation, doctors may prescribe drugs and tests more to protect themselves than because of good doctoring.
  • Managed care companies:
    • Sometimes doctors working with managed care insurers have to follow company standards rather than what they would do if left on their own.
    • Some doctors are forbidden from even discussing certain treatments.
    • Together, it's why some people say that "managed care" is really "managed costs" -- even though surveys show that people who have it are by and large pleased with managed care.
  • Doctors' financial interests: A doctor with a financial interest in testing companies or expensive equipment may tend to order unnecessary tests.
  • Specialties: More medicine these days is practiced by specialists in particular areas compared to the former general practitioner. As a general matter, experts tend to think in terms of their specialty first. If you talk to an insurance person, she will generally advise an insurance product for your needs versus a stock broker who will suggest a stock or bond answer. Likewise, doctors and specialists think in terms of their specialty. For instance, if you talk with a surgeon, she'll suggest surgery. A radiologist may have a radiological approach.
  • Discrimination: Without necessarily meaning to, women and minorities may not receive the same health care or treatments as a white male. The reasons may not be because of women or minorities as such, as much as for other reasons such as whether a doctor is affiliated with a hospital or has a broad range of specialists to call upon.
  • Amount of Information: With all the new medical information we are learning all the time, it is difficult for any doctor to know everything.
  • Training: Doctors are trained to treat disease, not balance the beneficial with the detrimental consequences of treatment for individuals. Also, few of them are trained in alternative/complementary medicines (non-Western medicine) or in the use of vitamins or herbs.
  • Staffing: Every aspect of medicine seems to be affected by the desire to keep staff to a minimum. The result is people who are overworked which can lead to mistakes.
  • Psychological: You are likely to feel more in control if you take charge in those areas where you can take charge. Even if the outcome doesn't change, you feel better day-to-day.

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