You see a surgeon, and she tells you you need surgery.
You see an orthopedist and he tells you you need physical therapy.
You see a chiropractor and she tells you you’ll need at least a dozen treatments.
You see an oncologist and he tells you you’ll need chemotherapy or radiation.
What’s wrong with these pictures?
Or maybe everything.
What may be lacking with their recommendations? Objectivity. You see, the surgeon doesn’t make any money until she cuts. And the orthopedist may not make money until you spend time in physical therapy. And the chiropractor doesn’t make money until she treats you. And the oncologist makes lots more money when you get treated in his or her center.
And it’s entirely possible that the only beneficiary of their treatment recommendations will be their wallets.
Don’t believe me? Then you haven’t heard the stories I’ve heard that would make your toenails curl. And you aren’t objective either.
When we are sick or hurt, scared and anxious, it’s very difficult to be objective in making medical care choices. Desperation does funny things to our brains. That’s one reason patients avoid second opinions. A provider holds out any carrot of hope, and we’ll jump at that instead of being more rational, stepping back, and pursuing other opinions.
And desperation, fear, or even mere confusion, can cause us to believe everything we are being told when, in fact, it would make more sense to examine the objectivity of the recommendations.
I’ve interviewed a cardiologist a number of times about this very subject. He tells of patients who, in the middle of a heart episode, get rushed to the emergency room. A stent is inserted into an artery to clean out a blockage. The provider, who makes his money by doing angioplasties and inserting stents says, “Mr. Smith, we can see a few more potential artery problems on the films we just took of you — why don’t we insert a few more stents while we are here? Is that OK?” And the patient concedes to the additional work, WHEN, in fact, the patient would be better off simply taking anti-clogging medicine to make sure ALL his arteries stay cleaned out.
And how would that patient know he was making the wrong choice? He probably wouldn’t. And who benefited from those extra procedures? Only the doctor who inserted the stents. The patient’s better choice would be to ask for his cardiologist to review the recommendations. After all, the cardiologist only makes money by counseling the patient, and not by performing treatments.
In my own situation, I was told I needed chemo immediately or I would be dead in six months. How did I figure out that was the wrong choice? By getting several other opinions and trusting my intuition. Who would have benefited if I had undergone chemo? Only the oncologist — it truthfully could have killed me!
How can sharp patients sort out these kinds of recommendations? Here are a few thoughts for double checking objectivity:
1. Assess whether the provider who is making the treatment recommendations can profit him/herself by performing the treatment. That’s not to say that if they can profit, it is necessarily bad. It’s only a way of determining objectivity.
2. If that provider does benefit, then ask about any alternatives they know of to that treatment. Is there a drug you can take instead? Is there a therapy that can relieve your pain instead of surgery? What about something like acupuncture? Their response — including their demeanor in reply — will give you clues as to whether they are objectively making your treatment recommendation.
3. Whether or not s/he tells you about alternatives — then ask if s/he is the BEST person to perform the therapy! Now, yes, I realize that is a silly question. No oncologist is going to tell you that you need chemo, then recommend that someone else actually provide the chemo! BUT — the way s/he responds, whether it is through laughter, temper, ego, or a sales pitch, will tell you quite a bit about the objectivity of the answer.
3. Trust your intuition. You can tell whether a doctor is truly recommending something in your best interest. You know whether s/he has listened to you to that point. You know how often you’ve been interrupted — or not. You know whether s/he is more interested in his/her ego or wallet than your well-being.
4. Research alternatives on your own before you decide whether to choose whatever recommendation was made. If the surgeon tells you there is no alternative to surgery, and you find out that, in fact, there is a drug that can potentially heal you, then you know the surgeon wasn’t being truthful (or worse yet, isn’t up to par on all the options.) If the orthopedist tells you physical therapy is the best alternative, and everything you read concurs, then you’ll have more confidence in the recommendation.
5. Finally — and if you can afford it, this is the very best way to do it…. Find someone who can make a truly objective recommendation to you. This isn’t easy, but it may be the only way you can get the very best care for your situation. You’ll need to find an advocate who understands the basics of healthcare (at the very least) and can guide you through the choices and decision-making. Or you’ll need to hire a service that can make the assessment for you. To date I have found only one such service — Lynxcare — and their objectivity and outcomes seem to be excellent. They will use your history, your records, your test results, and every other piece of evidence to recommend not only the right care for you, but the right provider for you, too. Their only stake is in YOUR well-being. Check them out.
The bottom line is to make sure that any recommendations made to us will be to our benefit. Good care, and the best treatment recommendations, will result in the most improvement that can be expected for the patient, at the least amount of pain and bother, at the least cost.
That’s not to say that others can’t benefit, too. A win-win situation is always the best! But treatment recommendations that result in benefits only to the providers, at the expense of the patient, are all too common. Don’t let yourself be a victim.
|Want more tools for sharp patients?
Sign up for Every Patient’s Advocate once-a-week or so email tips
Or link here to empower yourself at