Patient Responsibility

In discussing the idea of mandatory second opinions for newly diagnosed cancer patients ( a cancer support organization came to the conclusion that the patient must be responsible for his/her own body in lieu of another Federal or state regulation. That’s only logical. If I don’t care that much about my life, why should anyone else? We all hate regulations. We want to be free to drive as fast as we want and say and do what we want. Their solution was to stress education.

But what is education? Normally it is finding out what you can about a subject. Normally this is from a knowledgeable individual, an expert. In this case, it is how to treat a specific type of cancer. Our expert is the doctor who diagnosed us. He knows all there is to know about this cancer because he found it. Also he possibly brought me into this world, kept me healthy and alive all these years and probably did the same for several members of my family. Why should I question his prognosis?

Many cancer patients are dying, not because the treatments are not available, but because the initial physician failed to give the best possible treatment. Cancer is an unusual disease for many reasons – if you don’t treat it properly the first time, often there is no second chance because cancer grows geometrically. Often one treatment precludes the proper treatment from being given later. Doctors are humans and could make a mistake. Rarely is cancer diagnosed by an oncologist (It is generally diagnosed by an optometrist, gynecologist, urologist, dermatologist, GI, GP, etc.) and that doctor may not want to lose the revenue or admit that someone knows more than he does.

Dr. David Lawrence, a physician and former CEO of Kaiser Permanente, said that extrapolating from a Harvard study of medical care accidents in hospitals, these accidents are responsible for over 400,000 deaths per year; more than tobacco, stroke, diet, alcohol, drugs, firearms or automobile accidents. He defines these accidents as the misuse, overuse and underuse of medical interventions.

In discussing medical mistakes, Dr. Nancy Dickey, past president of the American Medical Association and former president and Vice Chancellor for health affairs at Texas A&M University stated, “The only acceptable error rate is zero, which means that as long as there is an error rate above zero, we must continue putting substantial effort into reducing the error rate still further. . . tackling errors is such a huge problem that we need to get our arms around pieces of it, make measurable progress, and then add another piece rather than being so overwhelmed that we don’t know where to start.”

Author of Time to Heal , Dr. Kenneth Ludmerer of Washington University said, “The pressure to see 50 or so patients in a day and to spend 6 or so minutes with each one is not enough time to say hello. This ill-guided emphasis on doing things quickly, rather than well, has certainly accentuated the problem of error.”

We are not fighting for what treatments a patient receives or from whom. All we care about is that the patient is entitled to make an informed decision. Being told that nothing can be done, that surgery is required tomorrow or take these pills and come back in 90 days is not making an informed decision. We know certain facts:

  1. Some people are cured from every type of cancer.
  2. There is treatment possible for every type of cancer.
  3. Cancer is the most curable of all chronic diseases.
  4. Cancer is an extremely complex disease, often requiring the knowledge of diverse specialists.
  5. Cancer must be treated promptly, properly and thoroughly.

Be responsible for your body, your life. Regardless of who does the original diagnosis or what the recommendation, get a qualified, independent second opinion to be certain you have covered all your bases. Then you are making an informed decision and have a good chance of fighting for your life.