I find myself constantly talking people out of medical care. Well, not so much talking them out of it as trying to talk them into seriously considering the evidence in favor of (or against) a test, procedure, or drug before undertaking anything. The big problem in American medicine today is that patients believe that "more = better." They use the same logic when buying cars, when ordering dinner, when building houses. And see where that's gotten us?

In medicine, the consumer mentality has been a disaster for patient outcomes. Of course, it's been terrific for drug and device makers. Fighting against them in defense of patients is so very difficult in this country, because we allow our medical care to be run as a "consumer-provider" system. What does this profiteering approach to medicine make our doctors? Salespeople.

But good doctors aren't salespeople. Good doctors follow the dictum my husband (an internist) uses constantly to admonish his residents: "Don't just do something! Stand there." Meaning? Meaning think before your act on a patient's body. First, do no harm. (A very modern idea, huh?)