One of the behaviors necessary to be a prepared patient is to "Seek and use the appropriate health care setting when professional attention is required."
So many judgments are packed into this brief statement!
We are all familiar with them: I have to live with the inconvenience of my cough and try to alleviate it. I have to decide when the cough has gone on long enough to be checked by a professional to see if I need a chest X-ray or antibiotics. Then I must match my situation with the setting (ER? Walk-in clinic? Doctor's office?). And if the latter, I must decide which among my doctors is best suited to treat me. Then I act.
At each step, I could stumble: Going to the ER for my horrible cough seems silly, unless I have pneumonia, which could probably be just as easily treated by my nurse practitioner the next day anyway. On the other hand, my nurse practitioner will send me off to my pulmonologist if my cough seems to be related to a previous lung problem. Which is the best choice, that is, the one that matches my need with the right professional in the right setting with the fewest stops in between?
Our health and our pocketbooks both depend on us making good judgments as we walk the fine line between underuse, misuse and overuse of the health care available to us.
These judgments become even more complicated when we are bombarded with advertising by drug and device manufacturers promising cures for ailments we hadn't considered as threatening to our ability to live long and well.
A new study in the journal Social Science and Medicine found the direct costs of the 'medicalization' of normal behaviors and states (such as body image, erectile dysfunction, infertility, male pattern baldness, menopause, normal pregnancy and delivery, normal sadness) are estimated at over $77 billion annually in the United States.
"You could say, that's not very much because it is under 4 percent," said Dr. Peter Conrad, author of the study, quoted in BMJ. "On the other hand, it is more than we spend on public health or cancer."
This innocuous descriptor deciding when to seek care and from whom and then doing it represents an ever-growing demand on us to understand how health care works and how to get the best results. Long-standing efforts like the Healthwise Handbook that focus on these specific decisions are good resources, but only if they are used. Most of us are mostly healthy most of the time, after all, so we don't understand just how many choices we have and the consequences of making the wrong ones
What can be done to ensure that we know just how much is at stake when we make the judgments to seek the right care for us, whether it's because we think we have pneumonia, fear we have a brain tumor or believe we would be more beautiful with a different nose?