“The More Each Patient Knows, the Easier My Job” – A Choosing Wisely Physician Story
This is one in a series of physician stories collected by Consumer Reports to share how conversations about Choosing Wisely are making a difference in patient care.
Uday Devgan, MD, FACS, FRCS
Ophthalmologist, California
“I’ve had so much fun giving out the Choosing Wisely wallet cards from Consumer Reports. I specialize in cataract surgery – the most commonly performed surgery done in the US each year – but I feel that all patients, no matter what kind of surgery or medical test or treatment they’re considering, could benefit from asking these five questions that are on the wallet cards:
- Do I really need this test or procedure?
- What are the risks and side effects?
- Are there simpler, safer options?
- What happens if I don’t do anything?
- How much does it cost, and will my insurance pay for it?
When a patient comes in to discuss whether cataract surgery is right or not for them, we give them one of the wallet cards. Most of our patients – probably 30 or 40 percent of them – have seen the wallet card before they even come in, since we have it posted on our website. But we give them a hard copy of it with their pre-operation package, along with answers that I wrote out to each of the questions.
Patients are surprised when we give them these materials; they realize I’m not trying to sell them the surgery. For me, the more each patient knows, the easier my job is, and the better off the patient is. I want them to have the answers to the same questions that I would ask. It just makes sense. In fact, when I had dental surgery recently, I asked the five questions beforehand. They’re relevant for all medical situations.
By using the wallet cards and the answers that I wrote out for them, I’ve seen some behavior change in patients. Some of my patients don’t want to have the surgery. And upon examination, we jointly realize that they don’t actually need the surgery yet. I tell them that there’s no rush to operate, and that if it’s not broken, there’s no need to fix it.
I’ve also shared the wallet cards with the residents I train, and they’ve embraced it. I give each of them a wallet card at their orientation, and emphasize the golden rule: We want to give the same treatment that we’d want to receive. We want to advocate for patients.
Using the wallet cards is a win-win; they make it easier for both sides. It’s better to have an informed patient, and it also helps the surgeon know that the patient is well informed and understands everything that’s happening.
It does take a little time investment – maybe two minutes more. We give them the card and the pre-written answers, and make sure they understand everything before they decide if surgery is the right option for them at that particular time. But we feel it’s important that they know the answers to each of the five questions – not just before cataract surgery, but also before any future medical procedure, head to toe.
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