Do you ever find yourself doing things just because you\u2019ve always done them that way? You\u2019re not really sure why \u2013 you just do it. Well, American health care is, in many cases, the same way. Health care providers go to school, learn to do things a certain way, and many keep doing them that way throughout their careers. Unfortunately, it turns out that some of these things, like having a chest x-ray before even a minor surgery when you have no signs or symptoms of lung disease, are not necessarily useful, are costly, and can even be harmful. Luckily, several health care professional associations have come together over the past few years and created the \u201cChoosing Wisely\u201d campaign to help stop some of this \u201cautomatic\u201d thinking and behaviors.<\/p>\n
The goal of the campaign is to encourage health care providers and patients to question what\u2019s being prescribed and why. For example, let\u2019s say you need surgery on your knee or shoulder. Your surgeon tells you the procedure will take about an hour and you will be in and out of the hospital the same day. You have never smoked, don\u2019t have chest pain or breathing problems, and you don\u2019t have diabetes or kidney disease. Yet, for some reason, your surgeon (or his\/her staff) sends you half way around the world to get blood work, a chest x-ray and an electrocardiogram (EKG or ECG) \u2013 and they are insistent that you have these things done a certain amount of time before your surgery is scheduled or you won\u2019t be able to have the procedure. You dutifully go and submit to this torture. If you are paying for this out of pocket, it will cost a pretty penny. If your insurance company is paying for it, these wasteful tests are costing the health care system tons of money. We all end up getting to pay more in premiums and taxes. And, for what? For something we may get very little useful information from.<\/p>\n
Often what happens with these excess tests is that some small variation of normal is found and then that has to be investigated \u2013 that means more blood work, maybe another type of x-ray or other image, or maybe a biopsy (when a little piece of tissue is taken from the body and looked at under a microscope to see if it is cancerous). At the end of it all, and several hundreds or thousands of dollars later, it turns out you really are fine and you have had to postpone your surgery needlessly. It is rare that any condition is found that would keep you from having your knee or shoulder operated on.<\/p>\n
So, how can these tests or procedures actually cause you harm? Often, people feel that they are not being cared for if their health care provider doesn\u2019t do a lot of tests. We have come to expect that lots of tests equal good care. But, many times, that is not the case. Every time you make a hole in your body, like when you have blood taken, there is a risk of infection. X-Ray radiation builds up in the body over time and can contribute to a person developing cancer. Sometimes, biopsies lead to more invasive procedures and treatments that are not needed. If your health care provider tells you to have imaging done that includes putting dye into your blood, there is always the risk of having a reaction to the dye that is potentially very dangerous.<\/p>\n
For decades it has been the standard operating procedure (pun intended!) to remove a woman\u2019s ovaries while she is having a hysterectomy to prevent developing cancer of the ovaries. The problem, sadly, is that the ovaries produce estrogen which helps to keep bones healthy. So, the woman who has had that surgery won\u2019t get ovarian cancer but she may very well develop osteoporosis, or thinning of the bones. Also, the spine can become bent over making breathing difficult and even a seemingly minor injury can result in breaking a bone. All of these risks might be worth it if your health care provider got some useful information that would change the course of your treatment or you weren\u2019t creating a problem by trying to fix another, however, many times, these tests or procedures are just not worth the risks.<\/p>\n
Some people might think, \u201cWon\u2019t my health care provider get upset with me if I question his\/her judgment?\u201d Yes, that\u2019s possible, but the question to ask yourself is, \u201cWhat\u2019s the bigger risk \u2013 my health care provider being upset with me or some potential harm coming to me?\u201d The interesting part about the \u201cChoosing Wisely\u201d campaign is that it was started by a physician, Dr. Howard Brody, who recognized that the standard ways of doing things are not necessarily the best ways. Dr. Brody and colleagues encouraged different specialist groups to actually challenge the way they thought about accepted procedures they had been doing because… well, just because.<\/p>\n
Since 2012, there has been a website for clinicians, patients and consumers of health care where you can find out more information about whether the tests or procedures being recommended to you are still the best idea (www.choosingwisely.org<\/a>). \u201cChoosing Wisely\u201d has also teamed up with Consumer Reports (www.consumerhealthchoices.org<\/a>) so that you can get the information you need in language that you can understand, instead of medical mumbo-jumbo. And, if your health care provider does get upset, my advice would be to find a new one. Health care should be patient-centered, not health care provider-centered, and shared decision making is the name of the game these days.<\/p>\n Wouldn\u2019t it be nice if we never had to even think about having surgery or being diagnosed with some dreaded disease? Yes, it sure would be. Alas, that\u2019s not the way it goes in this life. But, we can protect ourselves by asking the right questions \u2013 so, CHOOSE WISELY! Your health, and maybe even your life, could depend on it!<\/p>\n","protected":false},"excerpt":{"rendered":" Do you ever find yourself doing things just because you\u2019ve always done them that way? You\u2019re not really sure why \u2013 you just do it. Well, American health care is, in many cases, the same way. Health care providers go to school, learn to do things a certain way, and many keep doing them that<\/p>\n","protected":false},"author":10,"featured_media":6731,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0,"footnotes":""},"categories":[11],"tags":[],"class_list":{"0":"post-6513","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-and-happiness"},"_links":{"self":[{"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/posts\/6513","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/comments?post=6513"}],"version-history":[{"count":1,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/posts\/6513\/revisions"}],"predecessor-version":[{"id":6514,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/posts\/6513\/revisions\/6514"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/media\/6731"}],"wp:attachment":[{"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/media?parent=6513"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/categories?post=6513"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.tenfourmagazine.com\/content\/wp-json\/wp\/v2\/tags?post=6513"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}