As you read more stories about doctors profiting from the medical devices they use or about noninvasive medical treatments that can be used effectively as alternatives to surgery, you may wonder how you can be fully informed before making a major medical decision. Luckily, today there are many excellent Web sites available developed by respected medical organizations to help you sort through the issues and develop your own set of questions for your doctor.
While I'm by no means suggesting you should disregard your doctors, I am suggesting that you can become a true partner in your medical care. Any time a doctor has said to me after I ask a question about a particular treatment recommendation that either I trust him or go elsewhere, I've always decided to walk.
If my doctor won't answer my concerns during a regular visit and explain his choices, then I find a doctor who has more respect for me and my body and will discuss treatment options.
A good case in point about why we must all take back control when working with doctors is the Courage study, which was a five-year study (1999-2004) involving 2,287 people at 50 Centers across North America and funded largely by the Department of Veterans Affairs. Patients with partially blocked coronary arteries and chronic stable angina were randomly divided into two groups. One group had angioplasty with a bare metal stent implanted and included medication and healthy lifestyle changes. The other group just took medication and made healthy lifestyle changes, but did not have angioplasty and stent placement.
The study concluded that there was no meaningful difference in survival or reduced risk of heart attack with the use of interventional device procedures (angioplasty, bare metal stents) plus optimal drug therapy compared with optimal drug therapy alone.
When the study was first reported in the New England Journal of Medicine in 2007, experts predicted that billions of dollars could be lost in stent sales. While stent implants did fall off by 13% in the month after the study's release, stentings started again when the publicity died down. The Millennium Research Group indicates they are now back to peak levels.
So why have doctors ignored the findings and continued recommending stents? Probably because they make a lot more money with a stent procedure than they make managing a patient with drugs.
So what can you do to prevent unnecessary medical procedures and expenses? Your best weapon is the Internet and doing your own research when a doctor recommends surgery or other expensive medical procedures. Unless a doctor tells you that a delay in making the decision could kill you, take the time to do your own research, develop a list of questions about what your doctor is recommending, then make a decision in partnership with your doctor.
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