Consumer Savvy Critical To Health

Sep 25, 2014

Spend a lot of time investigating before make a big purchase? Most of us do.

But that's not always the case when it comes to medical treatments or drugs.

Dr. Steven Woloshin and Dr. Lisa Schwartz have been researching the misleading medical and pharmaceutical messages in advertisements and other media for years.

Dr. Lisa Schwartz and Dr. Steven Woloshin of the Dartmouth Institute Center for Medicine and the Media.
Credit Dartmouth College

As general internists and leaders at the Dartmouth Institute Center for Medicine and the Media, they spend every day separating hype from scientific evidence. The couple, who are married, want the public, policy makers, journalists and other physicians to become more discerning consumers when it comes to health.

“I feel it’s important that patients feel they can ask questions and get good answers from their doctors,” Woloshin said. “Because in the end, it’s the patients that gain the benefit or suffer the harm.”

The couple’s 2008 book, “Know Your Chances,” arms consumers with simple explanations about the math behind medicine. It’s available for free download from the National Library of Medicine. 

Mary Shedden, editor of Health News Florida, recently caught up with Schwartz and Woloshin about their mission to make patients more savvy about their health. Their interview is part of an extended discussion about savvy health consumers on WUSF's weekly public affairs show Florida Matters. See a preview of that episode here.

MS: A lot of times patients just want to hear the doctor answer just one question: What will make me feel better? How do you explain to patients that there are pluses and minuses to every medical procedure?

SW: We encourage patients to think about medicine the way they look at other things. If you’re going to invest in a car or buy a car, there are questions you would certainly ask. There’s a whole set of questions. People have well-honed consumer skills and we want them to apply them in medicine and a different arena. The same cognitive skills come into play.

 MS: Not all doctors are in love with the idea of being grilled by their patients. I wonder what are the questions you want patients to be asking their physicians when they are talking about treatments or prescription drugs?

SW: In medical schools you’re taught that if you see condition X, you prescribe drug Y. The emphasis is not on the doctors getting the basic facts about the drugs on hand. What’s the size of the benefit? What’s the size of the harm? And it’s surprisingly difficult to get that information in an easy, quick way.

LS: The idea is that if you are considering to take a medication or get a procedure, I think you want to ask a few basic questions. All right, what is the benefit? What are the different dimensions of the good things or the bad things I might avoid because of this drug? So what is my risk and my chance of this bad thing happening…and then you need to say, well, is the benefit worth the downside?

So, now I understand what I could get from it, and now I need to understand what are the bad things that could happen? Then you understand those things side-by-side. Now I have a chance at making an informed decision.

SW: And it’s probably a good idea to say what are other possible treatments as well. Sometimes there are different alternatives with a set of benefits and harms.

LS: And there have been a number of studies that show certain types of doctors are more likely to recommend procedures that they themselves do. You know, when you have a hammer, everything is a nail.

I think there were a few recent studies about cardiologists who do angioplasties being more likely to recommend that as a way to treat heart disease. So the idea is especially if you are seeing somebody who does something in particular – they may – whether it is just a belief in the procedure because they do it so much that they believe that it works, or you know they also sometimes they have financial interests.

So I think it’s really important to talk to people who don’t really have that kind of interest to get an independent opinion about the variety of options. 

MS: There is a lot of information out there about medical breakthroughs and miracle cures. You suggest people go to sources such as the National Library of Medicine. Why is that?

LS: The idea is that if the patient is going to sign up for something, they should know what they are going to get out of it or how they could be harmed in the process…. And a lot of the consumer medical information takes out a lot of the facts on the assumption people can’t understand them. And our point is that people really can understand them if given a chance.

--Health News Florida is part of WUSF Public Media. Contact Editor Mary Shedden at (813) 974-8636, on Twitter @MaryShedden, or email at shedden@wusf.org. For more health news, visit HealthNewsFlorida.org.