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Thomas Goetz

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How To Make Better Decisions For Your Health

Posted: 02/16/10 08:52 AM ET

Every day, we make dozens of decisions without thinking about them: what to feed the kids, how fast to drive to work, whether to hit the snooze bar. We make most of these decisions without a second thought. We go with our gut.

For other decisions, though, we have to pause, consider our options, and bring our best judgment to bear. This can be uneasy territory -- and it can get especially fraught with decisions about our health, when we often lack a strategy for weighing all the information on the table. We're not sure where to start.

But making smart decisions about our health doesn't have to provoke anxiety. It turns out we're well equipped to consider a range of options and make the right call. We just need to keep a few principles in mind. Here's my list of five strategies for making smarter health decisions:

1) Know Your Options

A few months ago, Dr. Dean Ornish invited me to visit with a group of men who had been diagnosed with prostate cancer. When most of these men were diagnosed, they were offered two options: Radiation or surgery. But Dr. Ornish put another choice on the table: a low-fat, vegetarian diet and exercise program. So every month, the group gathers in Dr. Ornish's office in Sausalito, California, to discuss their disease status, their progress in sticking with Dr. Ornish's plan, and their lives in general.

"I heard about this group and realized there was a third option," one group member told me. "There were behaviors that might reduce the chances that this cancer would kill us, without surgery or radiation. This idea that there was a third choice, another path, was completely unexpected."

Dr. Ornish has had particular success with this third path. A study of these men found that after significant lifestyle modifications--following a low-fat, vegetarian diet coupled with exercise, meditation, and weekly group meetings--the men's average PSA level dropped slightly while their free PSA (a positive measure of prostate health) climbed. And measures of stress, weight, and blood pressure had all improved.

This path isn't for everyone. Many men diagnosed with prostate cancer will still prefer to go the route of radiation or surgery. But that's not the point. The takeaway is this: These men thought there were only two options, both of them potentially destructive. But then they discovered more choices, a discovery that would turn out to add something to their lives. They had choices they didn't know existed. They just had to learn where to look.

2) Demand Relevant Information

In most health messages, there's a chasm between research and relevance, between what a study means and what it means for you. Take the recent study that found 55 percent of Americans have low levels of Vitamin D. So should you start taking supplements? Well, it all depends on your levels, doesn't it? Unless you know where you yourself stand, this research is pretty much useless.

This matters not just in terms of taking advantage of new research but also in making better choices day to day. Studies have shown that when information is targeted and tailored to an individual's circumstances, they are much more likely to act on it. Tailored information is relevant information, and relevant information is much more meaningful, and much more likely to result in better, healthier decisions (in other words, the outcomes are better).

3) Making Decisions Is Good For You

The old model of medicine dictates that when the situation gets serious -- when the decisions involve pain or discomfort or even life and death -- then the doctor should take over.

But the new model of medicine, that of personalized health, dictates that even in the gravest cases, the patient should be involved in considering the options and choosing the best course. And the evidence shows that this new model can actually deliver better care: in more than one study, patients who participate in their treatment decisions enjoy significantly better outcomes.

This isn't to say that when patients are involved, there aren't still serious risks. There's no such thing as a sure thing in medicine, and the risks of a procedure or path still need to be thoroughly communicated.

But when we do get involved, when we take a role in our health, we tend to have better results. And those are odds we all want on our side.

4) Small Decisions Matter

We sometimes think of healthcare as something that happens in our doctor's office, but really it starts with the multitude of smaller decisions that we make: what to eat, how much to sleep, how much exercise to get. These micro-choices add up -- indeed, they can have as significant an impact in our health as the big knotty dilemmas.

There is no sure thing, and just as the courses of our lives, in general, are bowed and bent by unexpected events, so too does our health course along uncertain trajectories. We can try to predict where things may go, we can try to prevent the worst from happening, we can try to extend the good and minimize the bad. But the more we're conscious of our every decision (no matter how small), and the more we take advantage of our every shot at improving our odds, the more we may influence where that trajectory takes us.

5) Make Every Decision a Good Decision

It's worth remembering just what a "good decision" actually means. Usually in medicine it's used to indicate a decision that leads to a better outcome. We want the treatment that either cures us or allows us to manage disease in a way that lets us make the most of our lives.

But a good decision also means the best possible decision, one that is carefully considered, draws on all relevant information (and avoids irrelevant information), and is consistent with how we want to live our lives. Even if these decisions don't result in the ideal result, we can know that when we consider our options thoroughly and make a sound judgment, we can be satisfied with that decision.

We can make decisions we can live with, and that will help us live better.

For more about the power of making better choices for health, read Thomas' new book, The Decision Tree, out today (Tuesday).

 
 
 

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