The long and the short of life is that illness happens to pretty well all of us -- even when we do eat our veggies. When we deal with bodily breakdown, the quality of our decision-making suddenly matters a lot.
One variable to consider is that different health-care paradigms will define you as "sick" at different points in an illness process. Chances are that if you see an allopathic physician with vague, not very severe complaints of frequent colds, tiredness or bloating, you won't get much in the way of diagnosis or treatment.
To a traditional Chinese medical doctor or naturopath, however, these are important subtle early warning signals.
No matter who your practitioner is, always ask questions to learn all your treatment options and potential risks. Once treatment is underway, consider whether you are getting results within a reasonable time frame.
Panic, grief and anger cloud decision-making. If you're distraught, put your choices on hold until you've released your feelings and found calm again. Patient support groups can be a great place to share feelings and get informed.
It turns out that Canadian researchers are at the forefront of developing decision-making aids for patients. One of the tools developed is posted at http://www.ohri.ca/programs/clinical_epidemiology/OPDSL/Ottawa_5Step_020620.PDF
WHAT THE EXPERTS SAY
"There is a lot of pressure from the (medical) system to act quickly, but people make better decisions if they take their time. I ask my patients to think about the risks of treatment and of not treating. Which treatments match their belief system? The placebo effect runs at 30 to 35 per cent effectiveness. If a placebo can be that strong, having your belief system on board will make the treatment more effective. Just because we don't believe in a treatment doesn't mean it won't work. But it will work better if we can find a way to integrate it in our lives." JEN GREEN, naturopath
"As soon as someone starts to feel mild discomfort, they should look into it. This helps prevent serious illness. Aches and pains, tiredness, anxiety, sleep disorders, irritability about things you could normally handle, reduced sexual desire, constant sighing, gas and bloating, skin breakouts, dry hair, lost hair, dry nails, dry mouth, constipation, red eyes, dry eyes, diarrhea, indigestion, feeling hot or cold, a tongue that's pale, red, cracked, enlarged, shrunken, wet or dry: these are all signs of imbalance of the body."
MARY X. WU, president, Toronto School of Traditional Chinese Medicine
"The first step is to get a good match with a physician. Patients should be aware that there may be new treatments evolving or new options for your conditions. And if you don't ask, often you're not told. Physician visits are very quick. To make the most of that time, prepare your case in advance: what are your symptoms, what triggers them. Try to get to academic-linked Web sites. Many alternative and complementary treatments don't necessarily have a lot of evidence for their outcome, but neither do many mainstream medicines. One shouldn't assume that natural approaches or treatments are without risk." GAYLENE PRON,
PhD, clinical epidemiologist, department of public health sciences, Sunnybrook and Women's College Hospital
"If the feelings are negative, your thinking will tend to be negative. It helps to learn how to identify feelings without applying them to your situation. If you can take your head out of the equation and just be with the feeling, you will learn how to release it fairly quickly. When you let go of all these so-called negative feelings, the ability to see the situation from a new perspective improves dramatically.'
RALPH GUTKIN, KARYN KLAPECKI, business consultants
"It's not unreasonable to seek a second opinion. The doctor's duty is to teach the patient in understandable language about all aspects of the diagnosis, including treatment options. Physicians have an ethical duty to acknowledge when they don't know something. The physician shouldn't abrogate responsibility for giving recommendations in the name of patient autonomy; some physicians will not be firm in guiding a patient for fear they're behaving in a paternalistic fashion.'
PHILIP BERGER, MD
"The Center for Shared Decision-Making was designed to address a situation where the medical evidence is equal for more than one decision. We hope to show that if people get decision support they will be happier with their choice. Even if, for instance, they choose a cancer treatment and get a recurrence, they will not regret the decision they made, because they were so well-informed."
KATE CASSIDY, Center for Shared Decision-Making, Lebanon, New Hampshire