Patients should know when to say no to medical treatments and procedures that could lead to unwanted consequences

In an attempt to get doctors to practice better “evidence-based” medicine, some authoritative American health groups have developed a list of over 130 “do nots” for doctors to take note of — procedures, tests and treatments that these experts feel are done and used way too often.

But to have maximum impact, I think this advice should also be aimed at the other half of the doctor/patient tandem. In fact, the most important medical lesson most patients need to learn is when to say “no” or “don’t.”

Learn to Say No to Your Doctor

Now, there are clearly way too many of these proscriptions for me to list them all, so I’ll just highlight a few of the don’ts that stood out for me:

  • Elective Caesarians: Elective Caesarian section in a pregnant woman before 39 weeks, a procedure that’s generally done for the sole reason of convenience (either the doctor’s or the mother’s), although we’ve known for a long time that babies born under full term, even as late as at 39 weeks, tend to have more developmental problems than babies born at full term.
  • Infant Reflux Medication: Using reflux medication for infants when they spit up “too much” because in the vast majority of cases, spitting up is merely a nuisance that all kids eventually outgrow.
  • Antibiotics for Respiratory Infections: Using antibiotics for common respiratory infections including sinusitis and “bronchitis,” which are most often caused by viruses and hence don’t respond to antibiotics.
  • Children's Cough and Cold Medication: Using cough and cold medications in young kids (in fact, as a firm believer that the only reliable remedy for cold symptoms is my mother’s prescription of chicken soup, I’d argue that such medications should be used much more sparingly in adults, too).
  • Pre-operative Screenings for Everything: Doing routine pre-operative screening tests for people about to undergo low-risk procedures (does your surgeon really need to know your hemoglobin level when you’re about to have an ingrown toenail removed?)

There’s a lot more to this list, but here’s the point I want to make: everything that’s done to you or for you in a medical situation (not just by doctors, but by all health professionals) carries potential risks and possible downsides.

For example, a recent study found that a significant number of women who receive a false positive report on a mammogram (a test with a fairly high chance of a false positive over a woman’s lifetime) will have negative psychological consequences up to three years following that result.

So, the most important thing to do to protect yourself from potential negative consequences of a test or a therapy is to ask a lot of questions. And if you’re not happy with the answers, then just say, “Well, maybe next time, dude.”

OK, maybe you shouldn’t call your doctor “dude,” especially when he’s about to do your vasectomy, but you get my meaning, right?

Dr. Art Hister is a medical writer and health analyst for Global TV.

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