Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.
Nancy Van Vessem, MD
Chief Medical Officer
We all need to be knowledgeable about medical decisions that affect us. New information comes out every day questioning tests and procedures that seemed to be the right thing to do just a few years ago. Recommendations can change because the overall value of a procedure or test isn’t known until it has been widely used for a few years.
Articles you may have seen include the August 2011 Newsweek article “One Word That Will Save Your Life: No.” or the AARP Magazine article “Four Surgeries to Avoid” (hysterectomy, complex spinal fusion, coronary artery stents for stable vascular disease and knee arthroscopy). If one of the tests or procedures discussed in the articles has been recommended for you, you may want to consider your options.
This is where information comes in handy. Tests and procedures should be appropriate for the individual who stands to benefit or experience harm. That person is you. What to do and whether to do it depends on your age, sex, family history, other medical conditions, symptoms and wishes.
Shared medical decision making is important. Several tools are now available which can help you make some of these tough decisions by knowing your options and what questions to ask your physician before the test or procedure.
Studies show that if you are a person with a low risk of colon cancer, after a normal colonoscopy you don’t need another for 10 years. Would you want to go in earlier? If you knew that for many stable blockages in the arteries which supply blood to your heart, medication and diet was as effective as getting a stent, would you want the stent? If you knew that there is no reason to check your blood glucose if you are diabetic and not on insulin (or a couple of oral medications), would you still prick your finger every day? All of these procedures are commonly recommended for Capital Health Plan members because that is just the way things have been done.
CHP Physician Consulting with Patients
Research at Dartmouth has shown for Medicare members, 30 cents of every dollar may be spent on care that is ineffective, inappropriate or redundant. On the other hand, a famous Rand study showed that only 54% of the time do people who are visiting their physician regularly get care that is widely recognized as effective.
So what should you do? Having a primary care physician who knows you and understands your goals is the best place to start when you have medical problems or questions about recommended care.
Capital Health Plan members can also access resources for unbiased information regarding pros and cons of procedures and tests through CHPConnect:
- View streaming videos from the Foundation for Informed Medical Decision Making which discuss common health problems such as breast cancer treatment, whether or not to get a PSA, back pain, knee arthritis, and uterine fibroids.
- Use Healthwise, a health encyclopedia with content provided and updated by a nonprofit U.S. company. There is information regarding the variety of therapies for conditions such as carpal tunnel, who is most likely to benefit from certain surgeries, and the percentage of patients who get better versus don’t get better.
Log on to CHPConnect.
Just as you will be the one to experience the effect of lifestyle decisions you make, you will also be the one to experience the effect of medical decisions made by you or on your behalf. Doing some simple research can make you more likely to get the outcomes you want.
Dr. Nancy Van Vessem, MD Chief Medical Officer
Dr. Nancy Van Vessem is board certified in internal medicine. She has developed innovative disease management and quality improvement programs promoting the use of best evidence medicine, propelling CHP to national recognition for quality of care.
Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.
At Capital Health Plan, we believe that knowledge is power—for patients as well as doctors. When you have accurate information about health and treatment options, you can work with your doctor to make the medical decisions best for you. That is shared decision making.
Free Informative DVDs and Videos.
“Shared Decision Making®” is also the name of an award-winning series of DVDs and videos available to members through CHP Health Coaching. The topics are:
- back pain
- enlarged prostate and prostate cancer
- breast cancer
- colon cancer screening
- heart disease
- depression
- end-of-life issues
- menopause
- osteoarthritis of the hip or knee
- uterine fibroids and abnormal uterine bleeding
When you have one of these conditions, you face treatment decisions—some that aren’t easy. Watching a DVD will help prepare you to talk with your doctor about options. The information may answer some of your questions and also help you think of others to ask your physician.
Research and Real Patients. Shared Decision Making DVDs summarize the results of medical studies about a condition; explain treatment or testing choices; and outline the possible risks and benefits of each choice. In the DVDs, real patients explain what they went through when making tough medical decisions.
Watching the DVD is step one: getting knowledge. The real decision making happens in the doctor’s office. You’ll have the power to help choose the right treatment choice for you.
How to Get the DVDs.
CHP Health Coaching is your source for Shared Decision Making DVDs and videos, as well as much more information. Call CHP Health Coaching at 850-383-3400. Health Coaches are specially trained nurses, dietitians, and respiratory therapists who are available to you by phone 24 hours a day, 7 days a week—at no out-of-pocket expense. You also can obtain additional information by following the links to CHP Health Coaching.
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