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Problem Thinking, Not Problem Care

Posted Feb 2nd, 2010 by Trisha Torrey

Sometimes we think we aren’t getting the healthcare we deserve, when the real problem is in our own heads!  Here are two examples of what I mean. While initially they seem unrelated, they may instead influence how you view your own health care.

The first was a lengthy and miserable bout last winter with the stomach “flu,” suffered by several members of my family. We were all miserable. One family member remarked, “I can’t believe the flu shot didn’t work!”

Hold that thought.

I read about the second failure in an article about outcomes from robotic prostatectomy. For some reason, patients believed that if the surgeon used the robot instead of a more traditional form of surgery to remove their prostate glands, then later, they wouldn’t have problems with leakage, incontinence or erectile dysfunction.  As it turned out, each of those patients suffered from some of those side effects for a period of time post-surgery, and all of them felt as if they had been duped into believing something about robotic surgery that wasn’t true.

So what do these incidents experienced by stomach flu patients and robotic prostatectomy patients have in common? While it seems like they are both examples of failures in health care, in fact neither one represented a failure of their care. Instead they are both examples of how we patients sometimes fail to manage our own expectations.

For starters, influenza, whether it is seasonal or swine flu, is an upper respiratory illness, not a stomach illness. Stomach “flu” isn’t really influenza at all; its real name is gastroenteritis. Flu vaccines are not developed nor intended to protect us from a stomach ailment. In fact, according to the Centers for Disease Control, there is no vaccine available to protect adults from stomach “flu.”  (Yes, stomach distress can be a symptom of influenza, but it is not the cause, nor is it the most prevalent symptom.)

The conclusion? The flu shot didn’t fail my family member because he didn’t get the flu. He was still protected from last year’s influenza because he got last year’s seasonal flu shot.  And, as it turned out, he never did get the real flu last year.

Managing his own expectation would mean that he would realize that by getting a flu shot, he won’t get the flu.  But it’s unrealistic to believe the flu vaccine will prevent him from catching all contagious ailments.

What about the robotic prostate surgery? This treatment for prostate cancer is promoted as minimally invasive, providing benefits like reduced pain and a quicker recovery. Men are also told that use of the robot will reduce the risk of the unpleasant side effects of incontinence and impotence.

But we patients too often read or hear what we want to believe and not what is a more likely outcome. “Reduces the risk” is not the same as risk-free. Unfortunately, the men who felt the robotic surgery was unsuccessful had turned their hopes into their expectations. The treatment didn’t really fail them because they are healthier minus their cancerous prostate glands, even if they suffered the side effects after all.  Further, regardless of how a prostatectomy is performed, most men will have side effects at first.  Over time those problems may eventually disappear.

We do ourselves a disservice by turning wishful thinking into our expectations.  We would do better to manage our expectations based on reality.  And if the outcome is better than that, consider it a bonus!

Learning everything we can about preventive measures, our diagnoses and treatment options, and understanding the reality of possible outcomes will go a long way toward how we feel about the success or failure of our choices. 

 

About the author

Trisha Torrey is Every Patient's Advocate. She is a newspaper columnist, radio talk show host, national speaker, and the guide to patient empowerment at About.com.

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