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Just Who Is Making Your Clients’ Medical Decisions?
A 58-year old man learns he has early stage prostate cancer. His urologist suggests he wait for a few months so they can test him again, then decide whether he needs treatment. But the man decides to get a second opinion to find a doctor who will treat him, because he just wants that cancer gone. It doesn’t take him long to find a doctor willing to treat him as much as he’d like to be treated. An 85-year old woman with diabetes has been diagnosed with breast cancer. Her doctor tells her she needs surgery to remove her breast, then six weeks of chemo. Scared and fearful, she thinks for a few moments, then agrees. ………………………… As advocates, we can’t (shouldn’t, don’t) second guess the decisions these patients have made. But when we look at these examples, and thousands of others, we realize the biggest challenge these patients have when they are newly diagnosed is that they don’t have an objective way to assess their options. And too often, they aren’t the ones making the choices. Instead they are defaulting to whatever a doctor has recommended, whether or not that’s really the best choice for them. Consider: Their doctors don’t have time (or won’t take the time) to fully explain their options or the ramifications of each. Treatment is what earns providers their income. It’s difficult to think of them as objective when the rent is due or the staff needs to be paid. Treatment is also what forces insurers to lose money, too often limiting possibilities that the patient doesn’t even know have been limited. Decisions (or agreements) are usually made by these patients based on their emotions, and not on objective information. Further, because no one has ever taught them to be smart patients, they aren’t really sure how to go about getting the information they need. Most don’t even know the right questions to ask. And perhaps the biggest piece missing from any of these provider-suggested solutions is that no one has taken the time to ask these patients what THEIR values, goals or priorities are! …