for your health
Healthy choices
Making the right medical decisions for you
By Heidi Smith Luedtke
EVERY DAY, people decide whether to take
vitamins, supplements and prescription medications; whether to undergo screening for
prostate, breast or colon cancer; and whether
the benefits of elective surgery are worth the
risks. They also decide what to do about common health problems like high cholesterol,
diabetes and heart disease. In some cases,
people must choose between options that
range from “wait and see” to invasive surgery.
“Our patients and family members tell us
they’re overwhelmed with information and
with conflicting expert opinions,” says oncol-
ogist and Costco member Jerome Groopman,
M.D., co-author with his spouse, endocrinol-
ogist Pamela Hartzband, M.D., of Your
Medical Mind (Penguin, 2012). “It seems like
there must be one right answer for everyone,
but most of medicine falls into a gray area.”
“Risk is a highly relevant thing to con-
sider,” says cognitive psychologist Gretchen
Chapman, professor of psychology at Rutgers
University. But, she says, it can be hard to
evaluate. People need to consider how data
were obtained and how they are presented
to get a clear view. Both facts and feelings
matter in medical decision-making. The
approach that’s right for one person might
be wrong for another.
Personality psychologist and Costco member
Heidi Smith Luedtke writes about health,
parenting and people skills.
Step 1
Assess your
preferences
Your views on these
factors provide a
foundation for decision making.
Naturalism
Some people prefer
natural therapies
over synthetic ones,
even when there are
no discernible differ-
ences, Chapman
says. Acknowledge
your biases.
Ask: Other things being
equal, do I prefer organic
options or cutting-edge
scientific treatments and
technologies?
Time
“Many decisions involve
trade-offs between now
and later,” Chapman
says. And people focus
more on the immediate
future than the distant
future. Take your sense
of urgency into account.
Ask: Do I want a quick
fix or am I willing to
accept short-term costs
to get long-term benefits?
Effort
Some options require
significant effort from the
patient. You may have to
change your diet, limit your
activities, take a leave of
absence from work or
attend numerous follow-
up appointments.
Ask: Am I prepared to
do what it takes to make
this treatment successful
for me?
Risk
“Risk perception has
a strong emotional com-
ponent,” says Chapman.
Even small risks may
feel frightening. Psycho-
logically, “there’s a
big difference between
no chance of death
and a one in a million
chance,” says Chapman.
Ask: How well do I
tolerate risk and how will
I cope with my fears?
Step 2
Get good info
Complementary data
from these sources
can help you weigh
the options.
Personal stories
may help you envision
how a decision might affect
your future, Groopman
says. That’s something the
numbers won’t tell you.
Be aware: A single
vivid example can sway your
decision, even if it is atypical.
Personal stories evoke strong
emotions and stick in one’s
memory. Your situation and
experience may be different.
Dig deeper: Put personal stories in perspective by
comparing them to data from
large-scale studies. A friend’s
tale about a horrific side effect
may seem less scary when you
learn few patients have any
problems at all.
Statistics summarize
average outcomes and risks
associated with your treatment
options and help you see the
big picture.
Be aware: The way a
number is presented can skew your
view, says Groopman. A treatment
that is 80 percent effective has a
20 percent failure rate. A drug that
boasts a 30 percent reduction in
your risk for heart attack sounds less
impressive if you know your risk is
only 1 percent without the drug.
Dig deeper: If possible,
get stats based on people who
are similar to you. Then look at
the numbers from several angles.
Chapman recommends converting
probabilities into frequencies. It’s
easier to consider “eight out of 100
patients” than an abstract 8 percent.
Doctors’ advice takes
research findings and clinical
experience into account. Your
physician may have decades of
experience treating thousands
of patients with the same problem.
Be aware: “Each of us—
doctors, too—has our own way of
thinking about medical issues,”
says Hartzband. Your physician
may lean toward certain options
based on her training, preferences
and insurance-coverage issues.
Dig deeper: Get a
second (or third) opinion if your
doctor’s approach is not consistent
with other data sources, including
your gut instincts. Your doctor, insurance company or a close friend can
recommend another practitioner.
Step 3
Find the best fit
The right decision for you is the one that offers the
best chance of success given your specific medical
situation and personal preferences. Your doctor can
help you sort out the information. But, Hartzband
says, “In most cases, the answer ultimately comes
from the patient.”
