Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

AHRQ Director Carolyn Clancy, M.D., has prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They will address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan. Check back regularly for new columns.

How many times have you heard family members describe the terrific results they received from a certain medicine or treatment only to hear that a friend had very different results?

It doesn't seem to make sense that one person had such good results and another person did not.

We're constantly learning about the benefits and risks of medicines and treatments. As you probably know, the U.S. Food and Drug Administration must approve all new drugs and devices before your doctor can use them. Drugs and devices are tested in groups that try to include people who are similar to everyone in the larger population. But when the drugs and devices are approved and used in a larger group of people of different ages and with different medical conditions, there can be unexpected side effects.

That's why I urge you to talk to your doctor about the benefits and risks of any medicine, treatment, or surgery you are considering. Getting that information will help you sort out your choices. It will also help you make a decision that considers your needs and preferences.

Every medicine, treatment, or surgery involves some risk. Even a medicine like aspirin has side effects for some people. However, for many people, the benefit of this widely used pain reliever is greater than the risk of taking it.

The benefits of some medicines or treatment are often clear cut, such as losing weight or getting your blood pressure under control. These benefits also can help your future health by lowering your risk of diabetes or heart disease. Think about both the short- and long-term benefits of medicines and treatments because both are important for maintaining good health.

Balancing benefit and risk is not always easy, depending on the medicine or treatment in question. For example, for most people, the benefit of a medicine to lower blood pressure is probably more important than the risk of becoming tired or dizzy after taking it.

On the other hand, something like surgery to lose weight may be so risky for some patients, such as those over age 65 with underlying illnesses, that any benefit it could give isn't worth it. Even though older patients might have serious health risks due to obesity, they also have a much greater chance of complications or death than younger patients who undergo this surgery.

How should you make decisions about your care when the information about benefits and risks doesn't give a clear answer?

First, keep in mind that for many treatment decisions, no perfect answer exists. For example, weight-loss surgery might be a perfectly good option for your 40-year-old cousin but not for your 75-year-old uncle with heart disease.

Next, recognize that you may have more than one treatment option. For example, if you have high blood pressure, you might be able to take a medicine that has few side effects and gives you the desired result. Or you may be able to control your blood pressure through changes in diet and exercise. Talk to your doctor about the pros and cons of different treatment options so your decision reflects what you want.

Even though I urge everyone to be active in their own health care, as a physician, I know that not everyone wants to be highly involved in these decisions. Some patients see their doctors as trusted advisors. They are simply not interested in seeking information outside of their doctors' recommendations.

But many other people think of doctors as their partners in medical care, a trend I find encouraging. These patients are very involved in making treatment decisions and want to know all of their options. Frequently, these patients want advice from their physicians but prefer to make the final decision on their own.

Regardless of your own preferences or style, it's important to know that benefits and risks are a part of every treatment decision. Asking questions about them will help you and your doctor arrive at a decision about a medicine, treatment, or surgery that is right for you.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Tips for Evaluating Treatment Advice  (Transcript)

Healthcare 411
Weighing the Benefits and Risks of Medication or Treatment  (Transcript)

Having Surgery? What You Need to Know
Questions to Ask Your Doctor and Your Surgeon
http://www.ahrq.gov/patients-consumers/diagnosis-treatment/surgery/index.html

Current as of March 2008
Internet Citation: Balancing Treatment Advice: Benefits, Risks, and Personal Choice. March 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/031808.html