Get Inside Your Doctor's Head: Ten Commonsense Rules for Making Better Decisions about Medical Care (A Johns Hopkins Press Health Book)
Phillip K. Peterson
Format: PDF / Kindle (mobi) / ePub
With so many medical tests and treatments and so much scientific and medical information—some of it contradictory—how can people make the best medical decisions?
Most medical decisions, it turns out, are based on common sense. In this short and easy-to-read book, Dr. Phillip K. Peterson explains the ten rules of internal medicine. Using real case examples he shows how following the rules will help consumers make good decisions about their medical care.
Get Inside Your Doctor’s Head provides advice about such questions as when to seek treatment, when to get another opinion, and when to let time take its course. Turn to the Ten Rules when you are weighing your doctor’s recommendations about diagnostic tests and treatments and use them to communicate more effectively with your doctor. As with all rules, the Ten Rules of Internal Medicine have occasional exceptions—and when evidence suggests that you are an exception, the relevant rule should be broken. Follow the Ten Rules to make decisions in the increasingly complicated medical world when you need guidance about health matters for yourself and your loved ones.
about his or her mistakes. • You need a doctor whose mistakes weren’t medical malpractice. Because we all make mistakes, you don’t want a doctor who thinks he or she is always right. If your doctor is defensive or arrogant when questioned about an unexpected bad outcome, think about finding another doctor. There is no practical way to find out about the number or kinds of mistakes your doctor has made. And it is difficult—if not impossible—to know whether the doctor learned from them. But you
unusual life cycle. Most of the time, it doesn’t cause any symptoms when a person becomes infected; instead, it lies dormant in the body. This dormant form of TB, called latent TB, is the kind of infection that, if we tested every person on the planet, we’d find it in one of every three of them. If a person’s immune system becomes compromised at any time after the initial infection, the TB bacillus can awaken and reactivate. This is the case in most immigrants who develop TB. It is thought that
1 in 150 children are born with congenital CMV infections every year in the United States. In fact, congenital brain disease caused by CMV is more common than fetal alcohol syndrome and Down syndrome. Congenital CMV infection is also the most common cause of hearing loss in children in the United States. About 1 to 4 percent of uninfected women acquire CMV infection during pregnancy. It is this so-called primary infection that puts a fetus at risk of congenital CMV infection. Given all this, it
(“experience-based medicine”). Generally speaking, this is especially true for surgeons. If, in their experience, a surgical procedure (or a medication) works, they will think twice before recommending something else. In short, doctors are reluctant to change what they are doing if their patients are doing well. (For more about infections in transplant patients and the benefit of antibiotics such as sulfisoxazole, see the appendix.) Applying Rule 2 * * * If it ain’t broke, don’t fix
emerged. As a result, there was a flurry of activity to develop antibiotics active against these bacteria. But by the end of the twentieth century, the pharmaceutical industry’s pipeline of new antibiotics had largely dried up. We now face a serious situation where we have no effective antibiotics for certain kinds of bacterial infections. The solution to this problem is complex, but one thing is clear: physicians and patients need to work together to limit antibiotic overuse and misuse. * *