By Rosemary Gibson. When we listen to experts, our brains turn off.  This is the finding from a study conducted by Greg Berns, a neuroscientist at Emory University.  Here’s what he did.  He asked 24 college students to solve a personal financial problem.  He watched their brain activity using a functional MRI and observed a lot of thinking going on.     

Next, the students listened to a financial expert who told them what they should do.  A second brain scan showed that the students’ brain activity had virtually ceased.  The lesson?  When we listen to experts, our brains shut down.      

When I heard about this study, I couldn’t resist applying the findings to how people make decisions about their health care.  Advertisements on television urge viewers, “Ask your doctor.”  In other words, don’t think for yourself.  Suspend your own thought process and do what someone advises you to do, even if it means you will be exposed to significant risks that are often glossed over.  

For optimal health, we can’t delegate the management of our health, or our health care, to someone else.  We need to own it.  This requires a shift from the notion of consent to informed choice. 

Here are 10 questions to help re-engage our brains in health care decisions.  Call it a Checklist Manifesto for Informed Choice:

1.           What is the procedure or test?
2.           What is the purpose of it? 
3.           What happens if I don’t have it or do “watchful waiting?”
4.           What are treatment options for the condition I have??  
5.           What are the risks and benefits of these options?
6.           What do the risks and benefits mean for me and my life?
7.           Do the risks exceed the benefits? 
8.           If surgery is being considered, how many of the surgeries has the doctor performed?
9.           Who will perform the surgery?  Will residents, or doctors-in-training, be involved?
10.           How many of these procedures have been done at the hospital where it will be performed?

There’s an added bonus to being fully informed.  Research shows that when people have their brains turned on and are engaged in making decisions about their health and health care, they use less intensive and costly approaches to treating their condition.  That can only be good for one’s health – and pocketbook.

One-third of Americans say they have received tests, treatment or medications they didn’t need, according to a survey conducted for the Commonwealth Fund of New York.  Are you one of them?

Think about it.  We live in a market-driven economy where businesses thrive on getting us to consume more than we need, whether it’s a house that’s too big, a mortgage that’s unaffordable, or an investment that promises more than it can deliver.  Market-driven health care is motivated by the same imperative.  In our highly-caffeinated health care system, the mantra is volume, volume, volume.  That ‘volume’ is you and me, and the people we love.

Here’s a story about a colleague, a research scientist, who has a heart condition that she watches very carefully. She went for a nuclear stress test at a free-standing diagnostic testing center as part of her routine monitoring.  After the test was complete, the cardiologist told her she had a very serious problem that required open-heart surgery.  She was scared out of her wits and immediately thought of a family friend who had died recently during heart surgery.  The cardiologist wanted to do a cardiac catheterization and prescribe medication.  He also told her to stop jogging immediately.

My savvy friend knew she didn’t want to have more tests or treatment at that center.  Here’s why.  While on the treadmill, she overheard the doctor tell the nurse that the center had nine patients a day and needed to increase its census to fourteen a day to generate enough revenue to make it financially viable.  It’s true.  She walked out and never looked back. A second opinion from expert physicians recommended continued monitoring and she followed their advice.

About ten years ago, the Institute of Medicine of the National Academy of Sciences convened a group of experts who acknowledged a uniquely American phenomenon in health care: overuse.  It occurs when the possibility of harm exceeds the possible benefit.  Health care insiders say that overuse is an epidemic.  Epidemics are not good for anyone.

To learn what you can do to avoid unnecessary medical treatment, check out my new book coming out next month, The Treatment Trap, which has twenty smart steps for consumers.  Read the foreword by Jim Guest, president of Consumers Union.  In the meantime, share your story.  Together we can learn from – and empower – each other.

With all the hand wringing about health care costs, it is possible to cut costs without harming patients. Even better, costs can be reduced while making patients better off. Here’s how.

An unspoken truth is that three kinds of medical treatment are provided in the U.S. The first is treatment whose benefit is unquestionable. Surgery to treat a ruptured appendix is an example. Without it, death from life-threatening infection is almost certain. The life-saving medical care being rendered to earthquake victims in Haiti is in this category.

A second type of treatment is provided when uncertainty exists about benefits and risks. Doctors and their patients must balance the benefits and risks. The recent mammogram controversy fits into this gray zone.

The third type of treatment is when the possibility of harm exceeds the possible benefit. A panel convened by the Institute of Medicine years ago called it “overuse”. This is the subject of my new book, The Treatment Trap.

Health care tests and treatments today are like the colors of a traffic light. Life-saving treatments flash green. Where uncertainty exists, the light flashes yellow. With overuse, the light flashes red and tells us to stop.

We don’t stop at red lights in health care. In fact, we run right through them. In a survey conducted by the American College of Physician Executives, eighty percent of physicians who responded said they were very concerned or moderately concerned about their physician colleagues overtreating patients to boost their income. Fifty-four percent said they were concerned about their peers admitting patients to a hospital to increase their bottom line. The survey respondents are in leadership positions in hospitals, medical practices and other health care organizations.

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