While the days of believing that doctors are all-wise and all-powerful are long gone, we still expect certain things when we walk into the doctor’s office. We assume that, first, there’s something that will help us and, second, that the doctor knows what it is. Most importantly, we assume that the doctor will be honest with us.
Unfortunately, that’s not necessarily true. And while most doctors probably don’t actively lie to their patients, they’re very good at withholding information. Sometimes they do it with the best intentions, honestly believing it’s “for our own good.” Sometimes they’re just jerks. Occasionally they’re actively dishonest, and sometimes they’re as much victims of the system as we are. Whatever the reason, the fact remains doctors don’t tell us a lot of things. Here are some of the most common things they’ll never say, but probably should:
“You don’t really need this test.”
There are basically two reasons for not telling us this. In our lawsuit-happy country, many doctors practice “defensive medicine.” That is, they’re so afraid of being sued that they’ll order every possible test simply to cover their butts. Do you really need an MRI because you have chronic headaches? Probably not. But your doctor may order one as a matter of routine, just to make sure he can’t be sued at a later date if you develop a brain tumor.
The second reason for ordering unnecessary tests is purely for profit. In hospitals especially, where tests are done in-house, more tests equal more money. The solution? Question everything. Ask if a test is really necessary, and if so, why? What are the benefits? The risks? Is it really going to make a difference in the long run, or is it just another way to lighten your wallet?
“There’s a cheaper alternative to this pill.”
While we like to think doctors know everything about the drugs they prescribe us, the fact is there are just too many things on the market for any one person to keep track of. That’s why the Physician’s Desk Reference exists. Given a choice of five different drugs with the same effects, which one do you think a doctor will prescribe? The one whose name he’s most familiar with, of course.
Fact: Doctors are influenced by advertising just like anyone else.
The marketing Big Pharma floods your TV with is nothing compared to the advertising it aims at doctors. When you add in kickbacks and perks, what drug do you think is going to come to mind first? Certainly not the cheap alternative drug that costs 5 cents per dose.
The solution? Ask how much a drug is going to cost you before you leave the office. Then, ask if there’s a cheaper alternative.
“Better insurance doesn’t mean better care.”
In fact, better insurance may mean even worse care. While those of us with cheap insurance will probably get the bare-bones treatment, the problem with good insurance is the possibility of over-treatment. Doctors, hospitals, and Big Pharma all have their eyes on your insurance policy, and great coverage means they can order more tests, more drugs, and more treatments of all kinds - whether you really need them or not.
“These treatments won’t stop heart attacks.”
At the first glimpse of heart trouble, your doctor will likely try to put you on drugs called statins (like Crestor or Lipitor). He won’t tell you that there’s no science to back up this expensive “preventative medication.” Many treatments keep being used because that’s just the way things have always been done. Cardiac stents are another one of those things. Medicare spends $1.6 billion on them annually, but there’s no evidence that they’re any more effective than drugs or lifestyle changes for preventing heart attacks. They do carry a lot of risks - like kidney damage from the dyes used, but the benefit seems to be wishful thinking.
“Your cancer might not actually be cancer - and even if it is, it might go away on its own.”
Over the past couple decades we’ve heard an awful lot about how “early detection” can be a literal life-saver, and the push has been to diagnose and treat cancers as early as possible. However, while early detection really is a life-saver in the case of some types of cancer, for others it may be more harmful than helpful. It can lead to a round of treatment including drugs, surgery, or radiation that’s unnecessary at best and downright deadly at worst.
But wait - doesn’t catching cancer it early make it easier to treat?
It does. The problem is, sometimes it doesn’t even need to be treated. Our immune systems attack everything from the common cold virus to - you guessed it - cancer cells. Too-early detection often “catches” tumors that, left alone, would be taken care of by the body’s own defenses without anyone being the wiser. This is especially true of lung and prostate cancers.
Another problem with early detection programs, especially mammograms, is that they “catch” all kinds of things which look suspicious but turn out to be harmless. While this might not result in radiation and chemo, it does lead to unnecessary tests and other procedures - not to mention stress and expense.
“I’ve been disciplined for bad behavior.”
While there are processes for disciplining doctors who’ve been unethical, you’ll probably never hear about the results even if you’re the person who filed a complaint. Likewise, unless it’s a case that makes the national news, you’ll never know it if your doctor has been sued for malpractice. Disciplinary actions are a matter of public record, though. If you think your doctor may not be on the up-and-up, you can contact your state’s medical board and inquire about his or her record.
Taking charge of your own health means staying informed. Knowing some of the information that doctors may hide from you gives you the chance to tackle some issues head-on, like: Do I really need this procedure? What’s going to happen if I don’t take this drug? Or wait to have this lump biopsied? And by the way, have you ever been sued for malpractice?
These are all good questions to ask.