Smart Decisions: Know Your Options

Overview

Throughout your life you have to make health decisions for yourself and your family. The decisions you make influence your overall well-being as well as the quality and cost of your care. In general, people who work with their doctors to make health decisions are happier with the care they receive and the results they achieve. It is important to share in every decision about your health.

Good health decisions can help you reduce costs and get better care. A good decision takes into account:

• The benefits of each option.
• The risks of each option.
• The costs of each option.
• Your own needs and wants.

Always ask why

Too much care can be just as bad as-or worse than-too little. Most medicines can have side effects. Medical tests can give false results that lead to the wrong care. Surgery almost always has risks. And anytime you get care, there is a chance of error.

When your doctor suggests or orders a medicine, surgery, a test, or any other kind of care, ask why you need it and what would happen if you waited. If you don't need it now, you might want to wait.

But also remember that there can be costs to doing nothing. The "wait and see" option is not always the best. If you don't get care when you need it and a health problem gets worse, you may face higher costs than you would have if you had taken care of the problem sooner.

Asking why can help you and your doctor make the decision that's right for you.

Know the pros and cons

Every treatment choice has pros and cons. It's up to you to know what they are. Your doctor can be a big help here, as can this Web site.

Partner with your doctor to help you understand what a decision might mean for you now and in the long run.

Remember, the goal is to get the care you need, no more and no less, and to get it at the lowest cost you can.

Think about your needs and wants

People value things differently. When you have a health care decision to make, you have to balance issues like:

• The desire for better health versus the risks of treatment.
• The certainty of doing something versus the uncertainty of waiting (the known versus the unknown).
• Convenience versus cost.

You are the only person who knows what mix is right for you. You may be willing to pay more if you can get the problem taken care of quickly. You may be willing to go through a very risky surgery if it could cure a serious health problem. Or you may be willing to put up with some pain if it means you can avoid a treatment with bad side effects or high cost.

For many decisions, these issues are just as important as the medical facts. They are part of what makes a decision right for you. They affect whether you get the care you want at a cost that seems reasonable to you.

Shared Decisions About Medical Tests

Medical tests are important tools, but they have limits. Informed consumers know medical tests have costs and risks as well as benefits.

Learn the facts

• What is the name of the test, and why do you need it?
• If the test is positive, what will the doctor do differently?
• What could happen if you don't have the test?

Consider the risks and benefits

• How accurate is the test? How often does it indicate that a problem exists when there is none (false-positive result)? How often does it say there is no problem when there is one (false-negative result)?
• Is the test painful? What can go wrong?
• How will you feel afterward?
• Are there less risky options?

Ask about costs

• How much does the test cost?
• Is there a less expensive test that might give the same information?

If a test seems costly, risky, or not likely to change the recommended treatment, ask your doctor if you can avoid it. Try to agree on the best approach. No test can be done without your permission, and you have the right to refuse a test.

Talk to your doctor

• What are your concerns about the test?
• What do you expect the test to do for you? Are your expectations realistic?
• What prescription and nonprescription medicines are you taking?
• What other medical conditions do you have?
• Do you prefer to have the test or not?

If you agree to a test, ask what you can do to reduce the chance of errors. Should you restrict food, alcohol, exercise, or medicines before the test? After the test, ask to review the results. Take notes for your home records. If the results are unexpected and the error rate of the test is high, consider redoing the test before basing further treatment on the results.

Decision Points are designed to guide you through key health decisions, combining medical information with your personal information to make a wise health decision. See a list of Decision Points about medical tests.

Shared Decisions About Medicines

The first rule of medicines is to know why you need each medicine before you use it.

Learn the facts

• What is the name of the medicine, and why do you need it?
• How long does it take to work?
• How long will you need to take it?
• How and when do you take it (for example, with food or on an empty stomach)?
• Are there nondrug options?

Consider the risks and benefits

• How much will this medicine help?
• Are there side effects or other risks?
• Could this medicine interact with other medicines or herbal supplements that you currently take?

Ask about costs

• How much does the medicine cost?
• Is a generic form of the medicine available and appropriate for you?
• Is there a similar medicine that will work almost as well and be less expensive?
• Can you start with a prescription for a few days to make sure the medicine agrees with you?

Talk to your doctor

• What are your concerns about the medicine?
• What do you expect the medicine to do? Are your expectations realistic?
• What other prescription and nonprescription medicines are you taking?
• Do you want to try the medicine or try other ways of treating the problem?

Decision Points are designed to guide you through key health decisions, combining medical information with your personal information to make a wise health decision. See a list of Decision Points about medicines.

Shared Decisions About Surgery

Surgery tends to come with high costs and risks. When the choice to have surgery is not clear, good decisions are even more important.

Learn the facts

• What is the name of the surgery? Get a description of the surgery.
• Why does your doctor think you need the surgery?
• Are there other treatments you could try first?
• Is this surgery the common treatment for this problem? Are there other types of surgery?

Consider the risks and benefits

• How might surgery help you?
• How many similar surgeries has this doctor performed? How many surgeries like this are done at this hospital?
• What results would you have to get from the surgery for you to consider it a success? How likely are those results?
• What can go wrong if you have surgery? How often does this happen?
• How long would it take to recover from surgery? How much time off would you have to take? What kind of rehab would you need?
• What happens in the short term if you don't have surgery? What might happen over the long run if you don't have it?
• If you need surgery, where should you have it? How can you reduce the chance of an error?

Ask about costs

• How much does the surgery cost? How can you find out?
• Can it be done on an outpatient basis, and is that less expensive?

Talk to your doctor

• How much does the problem really bother you? Are you willing to put up with the symptoms to avoid surgery?
• What are your concerns about the surgery?
• Do you want to have the surgery at this time?
• Do you want a second opinion? Second opinions are helpful if you have any doubt that the surgery proposed is the best option for your problem. If you want a second opinion, ask your primary doctor or surgeon to recommend another specialist. Ask that your test results be sent to the second doctor. Consider getting an opinion from a different type of doctor who treats similar problems.

Decision Points are designed to guide you through key health decisions, combining medical information with your personal information to make a wise health decision. See a list of Decision Points about surgeries.

Shared Decisions About Other Health Issues

Every solution to a health issue has benefits and risks. Only you can decide if the benefits are worth the risks.

Learn the facts

• What is the solution? Get a description of the solution.
• Why does your doctor think you need to try this solution?
• Are there other options besides this particular solution?
• Is this solution the common treatment for this problem? Are there other solutions to this health issue?

Consider the risks and benefits

• How does your doctor think this solution will work for you?
• What is the success rate? What does success mean to your doctor? What does success mean to you?
• What can go wrong? How often does this happen?

Ask about costs

• How much does the solution cost? How can you find out?
• Are there other costs to the solution, such as equipment or therapy?

Talk to your doctor

• How much does the problem really bother you?
• What are your concerns about the solution?
• Do you prefer to try the solution or another way of treating the problem?

Decision Points are designed to guide you through key health decisions, combining medical information with your personal information to make a wise health decision. See a list of Decision Points about treatments and other issues.

Related Information

• Better Care at Lower Costs
• Making the Most of Your Appointment
• Pediatric Preparation for Medical Tests
• Work Closely With Your Doctor

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