Navigating the Health Care System
Advice Columns from Dr. Carolyn ClancyFormer AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
Busting Myths About Health Care QualityBy Carolyn M. Clancy, M.D.
If you've ever watched the popular "MythBusters" program on the Discovery Channel, you know that many supposed truths are based on old, incomplete, or simply incorrect information.
The same thing can be said about beliefs about the quality of health care in America. How many times have you heard that more tests and treatments are better than fewer? Or that more costly care is better? And how can you avoid thinking that the latest treatment or medicine is better than one that's been used for years?
I wish I could disprove these myths with the same clear-cut results you see when "MythBusters" tests gadgets from James Bond movies.
Myths about health care quality often hold a grain of truth, which make them harder to prove false. The advice they offer might hold true for some people in certain cases. But carefully gathered findings from many different studies offer a better idea of what is likely to hold true for most people under most circumstances.
Let's take a closer look at some of the popular beliefs about health care quality to see why I think they are myths.
More services and treatments are better than fewer.
Every year, millions of Americans receive health care services that are unnecessary, increase costs, and may even hurt them. Research has shown that this occurs among all types of people—men and women, rich and poor.
As an example, in a study of hysterectomies (a surgical procedure in which the uterus is removed), researchers found that one in six operations was inappropriate. That means that 16 out of every 100 patients could have gotten better without undergoing surgery.
More expensive care is better than less costly care.
Like other myths about quality, this one is hard to prove false because some more expensive treatments and medicines can give better results. But this is often not true, and you can end up paying more for care without knowing a cheaper option is just as good or better.
For example, a study that looked at the use of antibiotics for treating ear infections in children covered by Medicaid in one State found that costly drugs were used far more often than they should have been. Costs could have been cut dramatically in one year—by nearly $400,000—if half of the antibiotic prescriptions that were written had been for a cheaper but equally effective medicine.
The latest treatment is always better than the one now in use.
Medicine is based on progress in understanding how diseases work and how the human body responds to new ways of fighting them. However, progress takes place in stages. Researchers often must look for answers to different questions that come up once a new drug or treatment is approved.
One recent example is the use of drug-coated stents, or mesh devices that open a patient's clogged artery. These devices lower the risk of heart attacks and other life-threatening cardiac disease. Many doctors thought that the drug-coated devices were better than the plain stents that had been used before because they give off medicine exactly where it's needed.
But after more drug-coated stents were used, some patients developed dangerous blood clots. After reviews by the Food and Drug Administration, doctors are now judging whether the newer stents are right for patients on a case-by-case basis.
I hope you can see why myths about health care quality are hard to prove false. Information that people think is a proven fact may just be one person's experience or the first stage of an ongoing medical discovery.
But you can act as your own "myth buster" by asking your doctor questions—lots of them. He or she should be able to explain why they believe a certain treatment or medicine is the right one for you or your family. You deserve health care that is based on evidence, not myth.
I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
Next Steps After Your Diagnosis: Finding Information and Support
Food and Drug Administration (FDA)
FDA Statement on Coronary Drug-Eluting Stents