Some tests can do more harm than good for some people. Photo: Peter BraigFor a surgeon pushing an operation, he was frighteningly honest about his work.
John, an active 70-year-old, was seeking advice about a painful skin condition on his leg when the doctor recommended a procedure.
“He was quite graphic with his description. He said ‘We’ll stab that and we’ll cut this and we’ll pull that up’. It was quite daunting,” says John’s partner and nurse, Johnette Walker.
“So of course we asked: Do we really need to have this?”
The couple believe this question might have saved John’s leg, and even his life. After a “terrifying” meeting with the surgeon who provided limited information for $187 over 15 minutes, Ms Walker says they sought a second opinion.
John and Johnette.
The next surgeon helped them realise the potential harms of the operation outweighed the possible benefits, so they opted for non-surgical treatment with a skin specialist instead.
Ms Walker says she was inspired to do more research than usual after reading a “Choosing Wisely” brochure, which included five questions people should ask their doctors before they get any test, treatment or procedure.
She said the first surgeon did not seem to like some of these questions, but she kept asking them anyway.
“We asked if there were simpler and safer options and he just said, ‘This is what I recommend’.”
Ms Walker says she and John also asked about the risks; what would happen if they didn’t do anything, and what the cost would be. The surgeon did not provide detailed explanations and was dismissive of the costs involved in travelling 550 kilometres for the operation.
“He ushered us out the door and said ‘Go home and think about it’,” Ms Walker recalls.
“John was so distressed when we left. He got in the car and drove the wrong way up a one way street.”
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The Choosing Wisely campaign is urging Australians to ask five simple questions to improve the safety and quality of their health care, and to reduce unnecessary and potentially harmful interventions.
The movement, being run by NPS Medicinewise and backed by 70 per cent of Australia’s medical colleges, has already provided dozens of examples of tests and treatments that should not be used in particular circumstances because they will do more harm than good.
The recommendations apply to tests such as colonoscopies, X-rays, and CT scans. The prescription of drugs such as long-term reflux medications, painkillers, antibiotics and anti-fungal treatments are also on the list, along with some laser eye treatments, urinary catheters, and treatments for low-risk prostate cancer.
Occasionally, asking the right question could be life saving. For example, it could prevent an unnecessary prostate biopsy that leads to a catastrophic infection or a colonoscopy that perforates a bowel or causes bleeding.
Robyn Lindner, from NPS Medicinewise, said the five questions were being promoted in community groups, by medical colleges, and in hospitals. She said people should not be afraid of asking questions even if their doctors are in a hurry.
“All health care has a benefit but there are also risks. You want to be aware of those (risks) so you can be well informed about what you’re agreeing to,” she said.
The group also recommends people book long appointments if they have a lot to discuss; prioritise the issues they need addressed before the meeting; take notes during the consultation; and take a relative or friend to listen in.
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