Service of “You Choose”
Thursday, March 9th, 2023
A friend was a talented interior designer. She would come to our home with a stack of fabric samples all of which were great choices. “Big deal,” you think. When it came to home décor, my husband and I had very different likes: He leaned to the formal and elaborate. I prefer the opposite. Yet she’d surmount that hurdle with ease and arrive with perfect color and pattern pitches for the pieces that needed upholstering. And we’d happily choose the finalists and the winner.
But you don’t expect that approach at a doctor’s office. Seems it’s a popular tactic these days. A few years ago my doctor, knowing I was going to visit a surgeon next, said, “I hope to goodness he doesn’t give you choices.” Sounded strange to me: I either needed a procedure or I didn’t.
Here are two examples in which the patient was asked to decide. In one, it involved which operation of several needed should take place first. The surgeon told the patient to choose. In the other, the same words were uttered about two powerful drugs. Neither patient is a physician. Without the background, how in the Sam Hill can a patient make the most judicious choice?
Had we made a bad selection of fabric the only damage would have been to our wallet. But a patient choosing door number one when it should have been door number three could be seriously up the creek.
There are exceptions. My dentist has warned me that a conservative approach and tricky fix for a dental crisis might not work and I’ve chosen to give it a whirl. Dr. Alan Jaslove is a spectacularly talented dentist and if anyone can carry out a challenging procedure, he can. I’m braced to tolerate the more costly alternative if he can’t pull off the difficult, less expensive one—he makes clear the risks.
And obviously there are countless examples of patients who refuse to take medicine the side effects of which are worse than the disease or who stop physical therapy or decline to follow suggested diets. But sometimes we need guidance from an expert.
I’m guessing that passing the buck to the patient approach is influenced by insurance companies in a litigious society. Can’t you hear it: Doctor to the judge: “Well Jeanne opted to do thus and such. I gave her the choice. I had nothing to do with her decision.”
Has a doctor—or anyone else, such as a builder–given you a choice you weren’t prepared or educated to make? Are the medicine and operation examples I described one-offs? Why do you think some doctors leave crucial decisions up to the patient without recommendation?
