Zimpapers Logo

Trust Marandure
Except in an emergence, you cannot be given a treatment or test without your “informed consent”. You must be informed of the risks and agree to the treatment. In a partnership, however, informed consent may not be enough. The real goal is shared decision-making, where you actively participate in every medical decision.

Why should you help make decisions with your doctor? Aren’t you paying him or her to know what to do? Well, the choices aren’t always black and white. With many health problems, there is more than one option. Consider these examples:

You have moderately high blood pressure [160/95]. Your doctor says that exercise and diet might bring it down, but most people don’t succeed that way. Your doctor recommends that you start on medication to control it. You would rather try exercise and lose weight than pills for the rest of your life. The best decision depends on your values.

Your three-year-old child has a headache and a fever. The doctor says it’s probably nothing to worry about. Then you mention your hunch that it might be meningitis. Some testing may be appropriate.

You have been suffering from carpal tunnel syndrome for several months. Your doctor is now recommending a wrist splint and a steroid injection. You would prefer trying just splint with aspirin first. If that doesn’t work, you will consider other medications. Your doctor agrees that it is a good plan. In each case, the treatment that you choose will have an effect on your life. Therefore, the best medicine for

you combines your doctor’s medical expertise with your personal values.

Eight ways to share in medical decisions
1. Let your doctor know what you want. Tell your doctor that you want to help make decisions about what to do for your health problems.

2. Do your own research. Sometimes you need to learn things on your own before you can fully understand what your doctor is saying.

3. Ask “why?” – Always ask ‘why’ before agreeing to any medical test, medication, or treatment. Asking why may help you discover another option that better meets your needs.

4. Ask about alternatives and understand the options your doctor thinks are feasible.

5. Consider watchful waiting. Ask your doctor if it would be risky or costly to wait a while (day, week, month) before treatment.

6. State your preferences. Tell your doctor if you prefer one option over another based on your personal desires and values.

7. Compare expectations. Tell your doctor what you are expecting from the treatment and ask if that is realistic. If appropriate, discuss side-effects, pain, recovery time, long term limitations, etc.

8. Accept responsibility. When you make shared decisions with your doctor, both of you must accept the responsibility for the outcomes.

There is need for shared decisions about medical tests. Medical tests are important tools, but they have limits. Some people think that the more tests they have, the better off they will be. Wise consumers know medical tests have costs and risks as well as benefits. To help you make good choices about tests for you, you need to:

Learn the basics.

What is the name of the test and why do I need it? If the test is positive, what will the doctor do differently?

What could happen if I don’t have the test?

Consider the risks and benefits. How accurate is the test? How often does it indicate that a problem exists when there is none (false positive)? How often does it say that there is no problem when there is one (false negative)?

Is the test painful? What can go wrong?

How will I feel after wards? Are there less risky alternatives?

Ask about costs.

How much does the test cost? Is there a less expensive test that might give the same information? Will the medical aid fund pay for the test?

Let your doctor know:

– Your concerns about the test.
– What you expect the test will do for you. Ask if that is realistic.
–  Any medications you are taking.
– Whether you are pregnant or have other medical conditions.
– Your decisions to accept the test.
-If a test seems costly, risky, and not likely to change the recommended treatment, ask your doctor if you can avoid it. Try to agree on the best approach. No test can be done without your permission.

Once you agree to a test, ask what you can do to reduce the chance of errors. Ask about food, exercise, alcohol, or medications to avoid before test. After the test, ask to review the results. Take notes for your home records. If the results are unexpected and the error rate of the test is high, consider redoing the test before basing further treatment on the results.

Share decisions about medications

The first rule of medications is to know why you need each drug before you put it into your mouth, rub it on your skin, or whatever. The same as with medical tests, there are a few things you always need to know about medication.

Learn the basics
– What is the name of the drug and why do I need it?
– How long does it take to work?
– How long will I need to take it?
– How do I take it (with food, etc)?
– Are there non-drug alternatives?

Consider the risks and benefits.
– How much will this drug help?
– Are there side effects or other risks?
– Could this drug react with other drugs that I am taking?
– How much does it cost?
– Is a generic drug available (same formula but at a lower cost)?
– Is there a similar drug that will work almost as well and be less expensive?
– Can I start with a prescription for a few days to make sure this medication agrees with me?

Let your doctor know:

Your concerns about the drug.

What you expect it will do.

All other medications you are taking (including over-the –counter drugs).

Trust Gumisai Marandure is a Naturopath Practitioner based in Bulawayo contact 0772 482 382 or email [email protected]