As you read more stories about doctors profiting from the medical devices they use or about noninvasive medical treatments that can be used effectively as alternatives to surgery, you may wonder how you can be fully informed before making a major medical decision. Luckily, today there are many excellent Web sites available developed by respected medical organizations to help you sort through the issues and develop your own set of questions for your doctor.

While I'm by no means suggesting you should disregard your doctors, I am suggesting that you can become a true partner in your medical care. Any time a doctor has said to me after I ask a question about a particular treatment recommendation that either I trust him or go elsewhere, I've always decided to walk.

If my doctor won't answer my concerns during a regular visit and explain his choices, then I find a doctor who has more respect for me and my body and will discuss treatment options.


A good case in point about why we must all take back control when working with doctors is the Courage study, which was a five-year study (1999-2004) involving 2,287 people at 50 Centers across North America and funded largely by the Department of Veterans Affairs. Patients with partially blocked coronary arteries and chronic stable angina were randomly divided into two groups. One group had angioplasty with a bare metal stent implanted and included medication and healthy lifestyle changes. The other group just took medication and made healthy lifestyle changes, but did not have angioplasty and stent placement.

The study concluded that there was no meaningful difference in survival or reduced risk of heart attack with the use of interventional device procedures (angioplasty, bare metal stents) plus optimal drug therapy compared with optimal drug therapy alone.

When the study was first reported in the New England Journal of Medicine in 2007, experts predicted that billions of dollars could be lost in stent sales. While stent implants did fall off by 13% in the month after the study's release, stentings started again when the publicity died down. The Millennium Research Group indicates they are now back to peak levels.

So why have doctors ignored the findings and continued recommending stents? Probably because they make a lot more money with a stent procedure than they make managing a patient with drugs.

So what can you do to prevent unnecessary medical procedures and expenses? Your best weapon is the Internet and doing your own research when a doctor recommends surgery or other expensive medical procedures. Unless a doctor tells you that a delay in making the decision could kill you, take the time to do your own research, develop a list of questions about what your doctor is recommending, then make a decision in partnership with your doctor.

Just to introduce you to some great Web sites you can use for whatever medical questions you have, I'm going to take you on an Internet tour to research stents, as an example. The sites we'll visit are great sources for information on whatever medical questions you have.

Our first stop will be the Mayo Clinic's Web site. When I searched for information on stents, I found an excellent article that discusses what is best: a stent, drugs or lifestyle changes. This article clearly describes when each is best. You can take an article like this to your doctor and let him discuss the options with you, and speak frankly about your ability to make the needed lifestyle changes. Whatever course of treatment you and your doctor choose, you'll be better able to understand what must be done to improve your health.

Next I stopped at WebMD, one of my favorites. There I actually found an interesting article on the use of stents and strokes. Okay, it's not the same subject, but it is an excellent article that addresses when stents can be a good choice for care and are actually less invasive than more risky alternatives. Obviously when you're doing your research, be sure you are looking at the right diagnosis for which your doctor is recommending treatment.

Another favorite, MyOptumHealth, had a good overview of the recommended Guidelines for Management of Chronic Stable Angina. As you can see, stents are not part of that recommended treatment. But from reading the Mayo Clinic article, I can see that the stent controversy involves diagnosis of angina. So I could print out these guidelines to show my doctor and ask why he disagrees with them if he's recommending a stent.

HealthCentral raised even more concerns about the different types of stents that can be used. In addition to that discussion, I found links to articles on the benefits and risks of using stents.

My next stop was at Harvard Medical School's PriMed Patient Education Center. There I found an excellent article on angioplasty, a treatment closely related to this discussion of treating angina with stents. In some cases, angioplasty can be recommended when you're experiencing heart pain and a doctor suspects a blockage. Yet the article states, "angio­plasty is no better than standard drug therapy at protecting you against a heart attack and carries small but real risks of causing a heart attack or problem requiring emergency surgery." So again, another treatment recommended frequently by doctors that could be treated by less invasive drug therapy.

As you can see just by looking at stents and heart disease, I found five excellent articles that can help you be a partner in deciding what's best for your own health care. Visit these Web sites and research any health issues you may have. Go to your doctor armed with solid information and a list of questions. Then you and your doctor can both be involved in making informed choices.

There are two other Web sites you may want to visit frequently when you're looking for more information. One is WrongDiagnosis.com, which helps you sort through your symptoms and develop questions. If you think your symptoms don't match what your doctor is telling you, you can use this site to help you dig a little deeper. I've linked to one of the basic symptoms, pain, to show you how, by using its symptom checker, you can narrow down the options.

The CDC is the last stop on this tour. This Web site is best used when you're looking for more information on a particular diagnosis. You'll find an alphabetical list of diagnoses linked to a wealth of information.

By taking the time to research your own health issues, you can take back control of your health care.

Lita Epstein has written more than 25 books including The Complete Idiot's Guide to Social Security and Medicare and The Pocket's Idiot's Guide to Medicare Part D.

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