Q. Will the new health care reform law do anything to prevent overuse?
A. Health reform legislation has proposed pilot projects that would reduce the incentive for hospitals and doctors to overtreat. This is unlikely to curb overuse anytime soon.
Q. What can be done?
A. People who experience overuse and who are harmed by it need to speak out. Doctors and nurses who see overuse need to blow the whistle. If the public and the professionals did this, overuse would be a front-page story every day in every newspaper in the country.
Q. How does fear play into overuse?
A. It's two-sided. Physicians want to provide the best care to their patients and don't want to miss a critical diagnosis. They want to cover all their bases because patients' lives are in their hands. Fear of missing a diagnosis drives overuse. Patients are afraid, too. Many will want everything done. They may be unaware that the risks could be greater than the benefits.
Q. How can we mitigate our fear?
A. One way to combat fear during an illness is to know that you are not alone. Reputable online communities, like the Association of Cancer Online Resources, offer a place where people in similar situations can learn from others about their experience of illness and how they manage it. Knowing that others have traveled the same path can mitigate the sense of isolation and gut-wrenching fear.
Q. What steps must a patient take to protect him- or herself against such overuse?
A. Let me give you a list:
One, if you are facing a medical decision about a procedure, ask yourself the following questions: What is the procedure? What will it do for me? What are the risks? Are the benefits greater than the risks? What treatment options exist that may be less risky and less costly yet achieve a similar benefit? How will my quality of life be affected? How much pain will there be and for how long? Will I be back to normal?
Two, obtain multiple opinions, do your homework, and look for a physician who you believe has your best interests at heart. Follow your gut instinct.
Three, be media-savvy. Don’t fall for marketing and advertisements. They will never tell you the full picture. If you sense a provider has a conflict of interest, obtain another opinion.
Finally, if you are considering surgery or a procedure and the decision does not have to be made right away, ask for the informed consent form a week or more before the procedure. Take it home, read it carefully, and write down the questions you have. Ask your doctor those questions, and have your questions answered, before making any decision.
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Tom Lombardo is a freelance writer in Atlanta. He was the founding editor in chief of WebMD and editor of the anthology After Shocks: The Poetry of Recovery for Life-Shattering Events.