Monday, February 6, 2012
The Trouble with Trust
When you're in the air at 30,000 feet, you probably want to trust the pilot. I know I do.
But there's usually just one commonly-accepted way to fly the plane. With most healthcare decisions these days, there are at least a couple of different paths your treatment could take. Probably more.
When you're faced with a healthcare decision of some significance, you can't lie back in the seat and trust the pilot. You've got to do some homework, get educated about the options from which you can choose, and ask your doctor some tough questions. Based on what you hear, you may need to get a second or third opinion to ensure you have considered all the potential options.
It's not that your physician isn't trustworthy, smart, committed, experienced or caring. You're not expected to know more than your doctor does about medicine, either. No. But you have a crucial role in deciding in what direction you'll go.
I have a good friend with a chronic healthcare condition who has, over the last few years, required a series of invasive procedures that have not solved her problem. When I talk with her about the potential value of seeking a second opinion at a time when she's not in crisis -- just to be sure -- I see a wall come up between us. "I like my doctor," she says. "I have to trust him."
Should she? Should you? To which I say: It's not about trust.
Trust means "total confidence in the integrity, ability and good character of another." When you're faced with a healthcare issue, the question isn't the integrity, ability or character of your physician, but rather whether you have access to the most advanced and effective approaches to your condition. When you're making a decision about your health, your physician -- no matter how well intentioned -- may not be aware of other alternatives, or may have not seen all the research or be familiar with a new diagnostic approach or treatment. Your doctor may even have a blind spot, a preconceived notion that could go back to his or her experience years ago in medical school or residency.
It's not uncommon for two physicians to disagree with each other. Who is to say, if you have physician A, that physician B might not offer a better approach to your situation?
Which is why I say that when it comes to getting critical advice about your health, understand that physicians can vary greatly in how they would recommend treating your condition. Find out what's available for you, learn the pros and cons and explore why physicians disagree about what is right for you. Discover what evidence is available to suggest a particular approach is good, better or best.
Then, and only then, you can trust that you've done all you can. In consultation with your doctor or doctors, you're ready to make a decision.
- Barbara Bronson Gray, RN, MN
- Barbara Bronson Gray is an award-winning writer and a nationally recognized health expert. She's a regular contributor to HealthDay and her writing appears in U.S. News & World Report, WebMD, Health.com, MSN Healthy Living, Center for Advancing Health and a wide range of other publications and websites. Barbara has worked in hospitals, as a nurse and as an administrator, led a major healthcare magazine, created and managed a website for WebMD, and served as a leader of global communications for Amgen, the world's largest biotech company. She continues to write and speak about healthcare and has a communications consultancy. Follow her on Twitter: @bbgrayrn.