How to Talk to Your Doctor About Unnecessary Tests & Treatments

Choosing Wisely, Dr. Lisa Bonang

How often do you question your doctor about the treatments they prescribe for you?

Do you ask questions about the risk or potential harm of some treatments or discuss safer options?

If you don’t, you should.

As a family physician, when I hear about lack of dialogue between a physician and a patient – whether it’s a personal story from a patient being dismissed by their doctor, or a doctor who’s given in to requests from their patient for a particular test – I find it worrisome.

I believe that the best health care always starts with a healthy conversation.

Physicians and patients are partners in care

A new initiative called Choosing Wisely Canada does just that – encourages physicians and patients to make decisions about health care together and to talk about the potential harms of unnecessary treatments or tests.

Choosing Wisely helps physicians and patients engage in conversations to make smart and effective choices to ensure the best possible care.

Physicians have a significant role to play in ensuring that Nova Scotians receive “appropriate care”. Appropriate care means that you get the right care, at the right time and in the right amount.

This requires doctors and patients to discuss treatment options rather than physicians simply dictating a course of treatment without discussing with the patient what is appropriate, what could be potentially harmful and what is overused and offers little benefit to the patient.

As physicians, we have a large role to play in ensuring that Nova Scotians receive the best health care possible – after all, we are the ones who order and complete most medical tests and treatments; therefore, we are best positioned to ensure our patients are receiving the best possible care.

In order to do this successfully, we need to work hand-in-hand with our patients.

Gone are the days (and rightly so) when a patient visits the doctor and the physician dominates the discussion and doles out the prescribed antidote without the patient participating in the decision-making process.

Patients want and need to be invested in discussions about their health.

I’m not suggesting that physicians blindly succumb to the wishes of the patient. It must be a partnership. Just as you – the patient – has the obligation to be as informed as you can possibly be, I – the physician – need to have a conversation with you about what is the most appropriate care plan for your unique circumstances.

Trust and dialogue improves your care

On a daily basis, physicians receive information on research, clinical practice guidelines and recommendations about what treatment is protocol, but choosing a course of action is really about the patient next to us – that patient’s risks, their concerns, their family history, whatever makes their issues at that time unique.

We must also be open to answering our patients’ questions and alleviating their concerns.

Ultimately, you – the patient – need to be fully informed of all of your options and about the potential risks or benefits of each option, and must feel free to choose the path that is the right one for you.

The best way to know what’s right for you is to talk to your doctor.

How to Talk to Your Doctor about Unnecessary Treatment

The next time you visit your doctor and are prescribed a course of treatment or test, ask your doctor these questions:

  • 1. Do I really need this test, treatment or procedure?
  • 2. What are the downsides?
  • 3. Are there simpler, safer options?
  • 4. What happens if I do nothing?

Sometimes the answers to these questions will change the course of treatment you receive.

Sometimes it won’t.

Either way, you’ll leave the doctor’s office feeling confident about your treatment and informed about your unique circumstances.

I believe that better communicating with patients doesn’t take choice away from physicians but encourages and supports better overall decision making.

The Choosing Wisely initiative, although new, has the potential to make a significant improvement in our health care system, but we need a massive culture shift in the way physicians think about and practice medicine.

The Choosing Wisely campaign needs to support physicians in having this dialogue with their patients. Patients too, need to be informed and supported by their physician to have this dialogue with us.

For many doctors, this is a change in the way we do business and the way we interact with our patients. It’s a change that’s needed to ensure our patients have a more active role in their own health care, to ensure we are using our health care resources more wisely and to deliver high quality patient care.

That’s what Choosing Wisely Canada is all about. It simply means better treatment, better access and better care.

For more information, visit bestcareforme.ca or choosingwiselycanada.org 

 

Dr. Lisa Bonang is a family physician in Musquodoboit Harbour and a champion for Choosing Wisely Canada in Nova Scotia.

Comments

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Submitted By: Judy Anaka

What do you do if you have a doctor that won’t listen to your concerns? I have to be stubborn and refuse recommendations they make after doing my own research on the topic? I dislike medication if there is an equal, safe natural alternative or life style change I can make. Perhaps we are just not a good fit but my choices are a drop-in clinic or having no family doctor. I can’t change doctors as there are few taking new patients unless you are a woman expecting.

Submitted By: Dr. Lisa Bonang

Hello Judy,

Thanks for your comment.

One of the most important components of good patient care is a healthy relationship between the patient and his/her family doctor. This means there is trust, respect and dialogue running both ways. As with any relationship, sometimes it takes a bit of work to get there.

I can’t speak directly to your situation, but in general I encourage patients to take the lead in trying to establish a trusting and transparent relationship with their doctor.

Rather than changing doctors, I’d encourage you to talk to the doctor you have and work together to build a stronger relationship where you can talk openly about your preferences and your physician can give you the best care and advice they possibly can.

All the best!