Five questions to ask your doctor to avoid overtreatment

When your doctor suggests a particular test or treatment, it’s OK to have questions. (Overtreatment can be a problem.) These five questions, adapted from the book Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, are intended to help you start a conversation and get the right care. If your doctor feels like there isn’t time to answer all of these questions in one appointment, it’s OK to ask for another.

1. What are my options? For many conditions and illnesses, there can be more than one treatment. Sometimes changing your lifestyle, such as your eating or exercise habits, can reduce your symptoms or risk of a bad outcome enough to make additional treatment unnecessary. Sometimes, not getting treated at all is a reasonable choice. Ask your doctor what your options are, and to explain each one carefully.
2. How exactly might the treatment help me? Sometimes patients have one idea about what a treatment can do, and the doctor has another idea.You need to know exactly what you stand to gain. A hip replacement, for example, might allow you to walk again with greater ease, but it won’t cure your arthritis, and you might need another replacement in 10 to 20 years. A drug might be able to relieve some symptoms and not others. Ask your doctor how the proposed drug or procedure is supposed to help you.
3. What side effects can I expect, and what bad outcomes might happen? Every test, drug, surgery, and medical procedure has side effects, and some can be very serious. Simply being in the hospital exposes you to the possibility of bad reactions, medical errors, and hospital-acquired infections. You need to know the risks so you can decide if the danger or discomfort of your condition is more worrisome to you than the risks of the proposed treatment.
4. How good is the evidence that I’ll benefit from the treatment? Many of the treatments and tests that doctors prescribe have never been adequately tested to find out if they work, or if they work in patients like you. You need to know if the treatment your doctor is recommending is a proven therapy. If not, your doctor should explain why he or she thinks it’s a good idea.
5. If it’s a test, what do you expect to learn from it, and how might it change my treatment? If the test won’t change the treatment, ask your doctor if you really need the test.

When you or someone you care about is in the hospital for a serious condition, such as heart failure, cancer, kidney failure, emphysema or any other advanced chronic condition, all of these questions are relevant. In addition, there is one more question and request you should make.

• Do you have a palliative specialist in this hospital? If so, ask for a “palliative care consult.” Palliative care specialists are nurses, doctors ad other health professionals who are expert in controlling pain. They also help patients and their families with important decisions, such as whether or not to have surgery. For patients who are in the terminal stage of their disease, palliative care can explain various options patients have around end-of-life care, and help them and their families decide what kind of care they want and need. You should not have to pay out of pocket for a palliative care consult.

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This post was originally published on December 2, 2015

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