Recently a Los Angeles Times article http://www.latimes.com * noted: “Patients never used to worry about making healthcare decisions. They didn’t have to. Their doctors made just about all of their decisions for them. Everyone simply assumed that doctors knew what was best.”
“But that paternalistic view of doctors as know-it-alls has gone by the board, says Dr. Clarence Braddock, vice dean for education at the David Geffen School of Medicine at UCLA. “Now doctors are seen as the experts on medical information and choices,” he explains, “but patients are seen as the experts on what those choices mean in their own lives.”
“The upshot? Doctors still make decisions sometimes, but sometimes patients make them, and sometimes doctors and patients make them together. Doctors and bioethicists are engaged in a vigorous debate about the relative merits of these various approaches. Meanwhile, you may want to consider which suits you best as a patient.”
“Your doctor is still the boss of you: Doctors make the decisions, but they also give patients a good rundown of their situation, answer questions and explain treatment options. The difference between this approach and the old one, then, is simply that patients are more informed. But that may be significant. Research has shown that the better patients understand doctors’ instructions — why they’re important, how they’re supposed to work — the better the outcomes for patients, quite possibly because they’re more likely to comply.”
“Patients call the shots: Again, doctors inform patients about their situation and options, but this time patients, not doctors, decide what to do. As one internal medicine specialist in the Baylor study said, “The ultimate decision is the patient’s…. You look at their medical condition, you know, present the options to the patient and then have the patient decide.”
“Doctors and patients collaborate: In this approach, so-called shared decision-making, they analyze situations together to reach a decision that both parties are satisfied with. “It’s a dance, a back-and-forth,” says UCLA’s Braddock.”
* to read the full LAT artcle “Scale of medical decisions shifts to offer varied balances of power” by Karen Ravn, highlight and click on open hyperlink http://www.latimes.com/health/la-he-doctor-patient-20140607-story.html
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Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.