This is a very important issue, which, imo, has not received adequate attention. Only naive individual believes the unaided human mind, no matter how intelligent and competent, can assimilate of all the pertinent literature/research on a health problem/condition, weigh its relative value and validity, and use it effectively to support diagnostic and treatment decisions (see, for example, the Knowledge Void and Information Overload). There’s simply too much to know, too many options and contradictions, information having questionable validity, big gaps in understanding cause and effect, and too many other things to consider that cross healthcare disciplines and knowledge domains (such as the mind-body connection and complementary & alternative care approaches), as well as the important of taking patient preferences into account and the possible need to adjust plans of care as a patient’s condition changes over time. And if a patient has multiple problems (coexisting/concomitant conditions), which is often the case, the complexity increases even more.

The healthcare industry, therefore, should focus on developing and using the kinds of tools that enable clinicians and patients to analyze a mind-boggling array of complex details related to diagnosis and treatment prescription, and select from a straight-forward list of well-care and sick-care interventions that present the following information clearly and understandably:

•  All the treatment alternatives shown by the evidence to be effective in treating the diagnosed condition(s)
• A rating of the validity and reliability of the relevant evidence-based research
• The degree of probability that each treatment option will be effective for a particular type of patient within the diagnostic group (i.e., take each patient’s medical history, characteristics, and demographics into account)
• If a treatment is successful, what degree of improvement in the patient’s condition can be expected (including symptom reduction and quality of life improvement)
• What the risks and side-effects of each treatment are
• The cost and price of each treatment by provider, as well as the degree of coverage by health plan
• The probable overall value (cost-effectiveness) of each treatment option (e.g., in QALY metrics)
•  Healthcare providers with expertise in delivering each treatment option.

Unfortunately, the current state of healthcare is nowhere near being able to do this, although things are just beginning to change. That means we’re all operating largely in a state of ignorance, and broken economic and competitive models often work against delivering quality care efficiently.

Bottom line: It is very important to be a proactive patient, but until our healthcare system focuses on generating the knowledge we all need to make wise decisions, there’s good reason to be very concerned and insecure.

Steve Beller, PhD
http://wellness.wikispaces.com
http://curinghealthcare.blogspot.com