4 Questions

In The New York Times’ November 22, 2015 Sunday Review, Ezekiel J. Emanuel, an oncologist and vice provost at the University of Pennsylvania, wrote an opinion piece, “Are Good Doctors Bad for Your Health?” In it, he discusses a Journal of the American Medical Association (JAMA) Internal Medicine analysis of 10 years of data: “It found that patients with acute, life-threatening cardiac conditions did better when the senior cardiologists were out of town.”   Dr. Emanuel points out there are no explanations for this fact.

Toward the end of his piece, Dr. Emanuel offers good advice; he says there are four questions patients should ask whenever their doctors are proposing an intervention (“whether an X-ray, genetic test, or surgery”). The four questions are:

  1. “What difference will it make? Will the test results change our approach to treatment?”
  2. “How much improvement in terms of prolongation of life, reduction in risk of a heart attack or other problem is the treatment actually going to make?”
  3. “How likely and severe are the side effects?”
  4. “Is the hospital a teaching hospital?” The reason for this, “The JAMA Internal Medicine study found that mortality was higher overall at nonteaching hospitals.”

Given the time constraints placed on medical professionals today, we need to be our own health advocates. It’s our health—the clock be damned. Don’t be shy about asking questions, and if necessary, ask for clarification and ask again. Get all the available information before making a decision, and if necessary, ask for a second opinion.

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