I'm shopping for a new doctor. Not because, I don't think my current doctor is not doing what he thinks is best, but because I want to make an informed risk assessment. Also, I think Doctors spend too much time telling people what they can't do instead of giving the positive message about what they can do.
Statistics are hard.
I am not a very good statistician, but I am an adult and I believe I know how to weigh statistical evidence. So I understand when someone says smoking increases your risk of hyperventilating by 200%, I know the follow up question is "What is the base risk of hyperventilating?" I'm believe this puts me out in the fringes of the standard population, but it does give me a way to make an informed decision.
I have border line high cholesterol. My doctor magnanimously put me on an expensive popular wonder drug that reduces cholesterol. In very rare instances the side effects of the drug can be life threatening. So here's the deal. I'm experiencing side effects from the drug. I may have side effects from all the related drugs. What I want to know is:
- What is the risk of dieing for someone my age?
- How is that risk impacted by my lifestyle? (I'm actually an outlier here)
- What is the expected benefit from taking the drug?
- What is the risk of having a life threatening reaction for people who react to the drug?
The last question is really the kicker - there may only be a one in a million chance for anyone who takes the drug to have a life threatening reaction, but since only one in one ten thousand people have a reaction, the risk of having a life threatening reaction goes up to one percent. Now I'm actually making my risk of death higher by taking the drug. And the drug works well, for most people. My problem is I can't find the studies that have the numbers, I need. Yet.
You can't have...
My Doctor also put me on a very restrictive diet without explanation. Nothing. Nada. Zip. Just a list of dietary rules:
- Don't eat...
- Don't drink...
- You can't have...
- Read product labels, you need to avoid...
I'm trying to back track the reasoning. The drug, I'm taking seems to induce symptoms similar to type 2 diabetes and high blood pressure - more side effects, I'm sure I'd rather not have without a good risk assessment. So now I have two more potential problems I didn't have before.
Curiously, there was a study just released that indicates what you choose to eat may be more important than what you
don't eat. What makes the study really interesting is the conclusion drawn by the researchers. The couldn't tell if it is the diet, or patients' willingness to follow the diet that was positive.
Taking this back to work
So what have I learned?
- Give as much information as you can when your asking someone to do something
- Tell people what they can and should do instead of what they can't
Just a thought. I could be wrong, but I believe that's right.