MORE ISN’T ALWAYS BETTER
Communicate to your doctor that “what you value most is not necessarily active treatment, but the time it takes to explain why a medicine or test may or may not be needed.”
Taking charge of your health means more than following expert advice blindly. It includes educating yourself about hidden influences that may affect your care—and ways you can signal to your doctors that you’re not just interested in a quick fix, but in the right answer. Veteran former Time health reporter and host of public radio’s Dueling Docs: The Cure to Contradictory Medicine, Janice M. Horowitz, deftly exposes background forces that can compromise care in her new book, Health Your Self (Post Hill Press, September 21). In this excerpt, she discusses how patient satisfaction surveys can skew doctors’ treatment recommendations to your detriment and what you can do to ensure your doctors dispense the best medicine.
IF YOU’RE LIKE ME, YOU IGNORED YOUR HEALTH woes large and small this past year, terrified that if you stepped foot in a medical center, packed with people sick from COVID-19, you’d wind up infected. Sometimes you did fine: the splinter worked its way out, your sniffles vanished. But other times, disastrously. Someone I know was too terrified to go to the E.R. when his vision turned blurry and by the time his wife convinced him, it was too late.
Now, with some measure of tepid freedom in many areas of the country, thanks to vaccines and fewer COVID deaths, we’re willing, at last, to take care of ourselves.
Before you do, be warned: there’s a hidden force at work every time you show up at medical centers such as urgent care and emergency rooms.
That hidden force is you.
Doctors in urgent care practices, emergency rooms, as well as some large medical centers, are particularly attuned to patient experience surveys that you may have filled out. Their interest in satisfying the patient may be not just to heal, but to gain high marks. My daughter had a killer earache that seemed to come out of nowhere, for which we rushed her to urgent care. The doctor’s prescription of antibiotics—which were not necessary for this new, feverless infection—and frequent double doses of over-the-counter painkillers was an easy way to show that he was doing all he could, and, if he was lucky, this would be his ticket to a five-star rating.
Good ratings aren’t merely good for a doctor’s ego. They come with perks. Better-rated doctors, particularly in urgent care, are rewarded with higher status in the clinic, and are less likely to work nights, weekends and holidays. In an emergency room, a doctor can’t get promoted if he or she consistently comes in with bad ratings. In fact, that’s pretty much true at any medical center that conducts patient surveys.
The result is that you, who have never been to medical school and don’t have clinical experience, are empowered with a disproportionate say in how well a doctor seems to be doing his job.
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