Are You A Passive Patient or an Active Consumer of Healthcare?
Think about the last time you made a big purchase. Did you go out and buy the first thing you saw? Or did you research it, learn some things, compare it to other options, and select something that was right for you? Most people tend to be educated and research large purchases like cars, or the newest iPhone. So why do we so often fail to do this with healthcare? By becoming more educated healthcare consumers, we can go from passive patients who take the first recommendation that comes from a practitioner to an active consumer who weighs options and makes choices. Here are some questions to talk through with your practitioner the next time a healthcare decision comes up.
What are the benefits or expected results?
When a treatment or procedure is recommended, the patient often assumes that it will make them “better.” But what the patient expects and what the healthcare provider expects are often two different things. For example, a patient having back surgery expects to be pain free after surgery. The surgeon probably doesn’t expect that to happen. Outcomes from back surgeries are not always the best. A large study of 1,450 patients in the Ohio worker’s comp system showed that after 2 years, 26% of patients who had surgery returned to work. Compare that to 67% of patients who didn’t have surgery. There was also a 41% increase in the use of painkillers in the surgical group.
What are the risks and downsides?
Patients want to hear about the benefits of a treatment, but they often don’t ask or care about the risks. To be an educated consumer, you need to. Going back to the back surgery study from before, the researchers found a 1 in 4 chance of a repeat surgery and a 1 in 3 chance of a major complication. These risks need compared with other treatments. In the case of back pain, physical therapy is a valid alternative with a much lower risk.
What are the alternatives?
Don’t feel bad asking about alternative treatments. If you were looking at a certain car, you wouldn’t go out and just buy it. You’d at least consider the competitors and probably even test drive them. You should look at the other options in healthcare too. Maybe the first recommendation that your practitioner makes is the right one for you, but if you don’t consider the alternatives you’ll never really know.
Why this treatment over the other ones?
This is the question where the rubber meets the road. You’ve learned about all the options, now you can see if your practitioner is balancing the risks and benefits to make the right choice for you. Staying with the back pain example, research shows that more than 40% of people who seek care for back pain will not receive a treatment of known effectiveness. Back pain is also the #1 reason for opioid prescriptions, despite a 2016 recommendation from the CDC to avoid prescribing opioids for back pain and opt for non-drug treatments like physical therapy.
What does it cost?
This last question is becoming more important as patients bear an increasing share of the cost of healthcare. That back surgery that we’ve been talking about- it’ll likely cost between $60,000 and $80,000. Consider this, a patient who chooses surgery first will spend $60,000 and have a higher risk of disability, and a higher risk of painkiller use, while risking infection, etc. An educated consumer would learn that physical therapy is a viable alternative to surgery with comparable outcomes, much less risk and lower cost. In fact, a large study of 122,723 subjects showed that people with back pain who got physical therapy in the first 14 days lowered their healthcare costs by 60%. It’s easy to see why bargain shoppers love PT!
