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?)
This past week, the BMJ (British Medical Journal) blog published "The New Therapeutics: Ten Commandments," a little ditty that proves the old adage that a lot of truth is said in jest. These humorous commandments, by John Yudkin, remind physicians how to think past the games that drug and device makers play with "science" to really think scientifically and ethically about patient care.
To get the jokes in the piece, you have to be a medical insider. But reading them, I realized it would be so great if American patients understood the ideas in the "Ten Commandments," too. So I asked my mate, Aron Sousa, MD, Senior Associate Dean for Academic Affairs at Michigan State University's College of Human Medicine, to help me translate into plain English Yudkin's "Ten Commandments." My translations aren't funny, but if you can understand them - and if you can somehow hold your doctor to them - you will likely live longer and better.
Don't be a consumer. Be a patient patient, and teach your doctor to be a patient doctor who thinks about what you really need from her or him. Do that, and you'll give your doctor a better life, too.