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Never Fear: Patients Have A Right To Know

Special to TBO.com

This book explains how pharmaceutical companies, surgery centers, and even the media use hyperbole and fear to get your attention.

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By MARY SHEDDEN | The Tampa Tribune

Published: December 19, 2008

Warning: Don't Freak Out!

That's the kind of label Steven Woloshin and Lisa Schwartz would love to see slapped on all the advertisements and public service announcements tied to health care. You know, the ones saying:

•Brand X cuts the risk of stroke by nearly half.

•Forgetful? Repeating questions? Having trouble finding words? A medicine called Brand X may help.

•The early warning signs of colon cancer. You feel great. You have a healthy appetite. You're only 50.

Woloshin, Schwartz and their fellow doctor, H. Gilbert Welch, have spent years researching medical messages and hype at the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire. They say pharmaceutical companies, surgery centers and, yes, the media are guilty of using hyperbole and fear to get your attention. But in most cases, you're not being given enough information to make a wise and rational decision about your own health care.

Now they're taking their no-nonsense message out of academia and hoping mainstream Americans will start asking advertisers and their doctors about what all of it means to their individual situation.

"Know Your Chances: Understanding Health Statistics" (University of California Press, $16.95) aims to strip the intimidation out of health statistics by suggesting you can get the information you need by asking basic questions about risks, benefits and external influences. For example, the ad about reducing the risk of stroke begs a follow up: "It cuts the risk by half of what?

"People kind of believe a lot of the health messages out there. ... There are a lot of implicit or implied claims. It's just accepted," Woloshin says.

"Knowing Your Chances" is written in plain speech and serves as a great reminder that those medical claims should always be evaluated by how they affect you and your current state of health.

In the interest of full disclosure, I first learned of their work when I attended a course they led about medicine and the media. But they in no way suggested I write about the book, which was funded by grants from the National Cancer Institute and the Robert Woods Johnson Foundation.

The book also tries to break down any intimidation people may feel about statistics or special knowledge physicians may be privy to. Schwartz says a lot of the problem stems from patients' feeling that they shouldn't ask questions because doctors must know best.

"There's a fear they will be perceived as bad patients," she says.

Woloshin, Schwartz and Welch are internists at the VA Medical Center in White River Junction, Vt. And Woloshin admits he gets uncomfortable when a patient pushes and pushes him for answers. But it's part of the job to answer those questions, he says.

"If you can't get the answer, be cautious," he warns.

That includes asking doctors if they received a financial incentive to recommend a treatment or medication. If a doctor gives you free meds at the office, ask why they're free. It may be the newest drug available, but you should question whether it's the best option for you medically or financially.

Patients need to know there's nothing wrong about being skeptical, Woloshin says. After all, you are the best person to be asking those questions.

"People know more than they realize," he says. "They really do have the skills."

Ask Before Taking:

Wondering what a medical advertisement or news story really means? Here are some key questions to ask about risk:

Risk Of What? Understand the outcome of a particular medical situation.

How Big Is The Risk? Know your chance of experiencing the possible outcome.

Out Of How Many? You must have total numbers to calculate your own risk.

What Is The Time Frame? One year, five years, in my lifetime?

Does The Risk Information Reasonably Apply To Me? Is the message speaking to people of your sex, age, current health?

How Does This Risk Compare With Other Risks? Get perspective and see just how big the particular risk is.

Source: "Know Your Chances: Understanding Health Statistics."

Want to share your health and fitness idea? Contact me at (813) 259-7365 or mshedden@tampatrib.com

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