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We wouldn't have to change the culture of medicine if there wasn't some controversy to overcome. Frequently Asked Questions (FAQs) and objections are discussed here.

There are lots of barriers to achieving a "Less is More Approach" to medicine. Fear of taking this approach too far and winding up with "too little" medicine is probably the most common apprehension.

Overall, it should be clear by now that the message is this: we need to think twice before ordering a test or pursuing a treatment; the primary reason for being careful is that harm can come from tests and treatment, just as much as it can come from not ordering the right test or treatment.


Preamble:

There is no one solution for everyone. Overall, whatever the decision, it should be made with both the healthcare provider and the patient working together. This is Shared Decision Making (SDM) which is a part of patient-centred care.

Being a physician as well as having been a patient with a serious condition myself – I was diagnosed with Transverse Myelitis and am told I'm likely to develop Multiple Sclerosis in the future (see my blog about it here) – I feel I can speak from both sides of the experience. I know how scary it would be if I felt abandoned or like my issues were not investigated or treated to the extent I thought was needed. At the same time, I am also nervous about the risks of tests and want to know what I'm, getting into before starting down any path.

One of the major goals of this website is to stimulate discussion. Once we get talking about it, we can generate ideas about how to effectively educate the public, empowering patients and their providers to make wise decisions together. Some of the (exaggerated) objections to Less is More are examined below.

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From Patients:

1. "You have to order that test! My mom had it done and it found her cancer!"

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2. "The other doctor did an x-ray/gave me antibiotics/checked my thyroid, so why won't you!?"

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3. "What about preventative health? Isn't that the most effective investment?"

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4. "I found this thing on the Internet. And I want you to do it."

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From Healthcare Providers:

1. "I don't care what it costs, I'm going to order that test. I don't want to get sued! It's better to do something than nothing!"

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2. "There was this one case, and the lady had a (insert rare diagnosis), and it was horrible. I'm never going to miss that diagnosis again! Any patient with (insert a symptom) gets (invasive, expensive, not very accurate test), and that's my standard of care."

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What do you think? Are there reasons to fear a Less is More approach? Is it a slippery-slope? Do we have it all wrong? Email your thoughts or tweet them to @LessIsMoreMed