Here is a glimpse of the book called Your Medical Mind by two Harvard doctor couple and what the authors have to say about making medical choices.

  Team@CMHF

Critical medical decisions can be difficult to make — even for two Harvard doctors. But Dr. Jerome Groopman, who is also a staff writer for the New Yorker, and his wife, Dr. Pamela Hartzband, have thought a great deal about doing it correctly.

In their recent book, Your Medical Mind: How to Decide What Is Right for You, they explain that a better understanding of your own personal values and history can help you cut through the swamp of statistics and make smart decisions.

What are the different types of medical mindsets?

The first one would be ‘minimalist,’ and the opposite of that is ‘maximalist.’ The minimalists like to do the least possible for medical problems and the maximalist wants to be ahead of the curve and do anything and more. For me, I am minimalist and [Dr. Groopman] is a maximalist.

Another major category, which we also differentiate is ‘believers’ and ‘doubters.’ Believers are people who believe there must be a good solution for their medical problems someplace, and they just have to find it. Doubters are very focused on side effects and on unintended consequences. They are concerned that the treatment might be worse than the problem.

One of the most difficult medical questions right now seems to be screening, particularly for prostate cancer. The studies suggest that men have to make a horrible choice between possibly dying of cancer or potentially becoming impotent and incontinent because of needless treatments after a false-positive result.

The U.S. Preventive Services Task force says no screening, and the Urological Association says everyone should be screened. The middle ground is that each individual patient and doctor makes a choice that’s right for that man. You have to be very careful. You need to really look deeply at these kinds of controversies.

How about the idea to have evidence-based guidelines for treatment that will just tell you what to do?

Guidelines can be extremely helpful and they represent a lot of work and gathering of information and weighing back and forth of evidence. But they’re not gospel. They’re often based on studies that don’t apply to many different people — pregnant women, for example, or older people or people with other medical problems.

How do you find and evaluate the information to make decisions?

The first question every patient should ask is, ‘What is my chance of having a certain outcome with no treatment?’ [In the case of statins, for example, a heart attack.] That gives the sense of, for you as an individual, what are you facing?

It clears away the confusing clutter of statistics. Either your doctor can provide the information, or there are [risk] calculators at government or other well-respected websites. [You need to find out] what is my risk for something if I do nothing, and then you can really assess the positive impact and negative potential complications of the treatment.

People make life and death decisions based on their interpretations of this information and it’s very easy to be misled. A lot of this book is about how not to be misled.

Ref:  http://healthland.time.com/2011/10/28/mind-reading-two-harvard-docs-talk-about-making-the-best-medical-choices/