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deborahjrossFrom Musings of a Dinosaur, by a family practice doc, a thoughtful essay on weighing risks:
In this case, though, we have a patient for whom a particular medication holds a real chance for significant improvement in quality of life despite a known, documented increased risk of an adverse cardiovascular event. Why don’t we factor quality of life considerations into the decision-making for patients who aren’t dying? The RISK of a heart attack is not the same as a heart attack. Whose comfort level with risk is more important here, the doctor’s or the patient’s?
Perhaps a more important question is, who gets to make the choice? The doc who might be faced with a lawsuit or hassled by the pharmacy benefits manager of the patient's insurance carrier, or the patient who will live with the consequences of the either decision?
Do read the comments from other physicians, as well.
In this case, though, we have a patient for whom a particular medication holds a real chance for significant improvement in quality of life despite a known, documented increased risk of an adverse cardiovascular event. Why don’t we factor quality of life considerations into the decision-making for patients who aren’t dying? The RISK of a heart attack is not the same as a heart attack. Whose comfort level with risk is more important here, the doctor’s or the patient’s?
Perhaps a more important question is, who gets to make the choice? The doc who might be faced with a lawsuit or hassled by the pharmacy benefits manager of the patient's insurance carrier, or the patient who will live with the consequences of the either decision?
Do read the comments from other physicians, as well.
