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Overview

Before agreeing to a treatment: 

  • In general: 
    • Keep in mind that it is your right to decide what treatment to undergo - or even to refuse treatment. 
    • Usually there is time before a decision has to be made. Ask the doctor how much time you have without endangering your health. You can take the time to explore the treatment and alterantives until you feel comfortable with a decision.
  • Before asking questions:
    • Before focusing on questions to ask, it helps to think about what is most important to you about your treatment. For example, you may want to take a treatment which has the least effect on your work, or one with the least side effects. 
  • Questions to ask
    • Ask every question that is important to you and get answers that you understand.
    • If the doctor doesn't have time to answer your questions, ask when you can speak again to cover the rest of your questions (via phone, fax, email or in another appointment.) If the doctor doesn't have time, you can ask a nurse, social worker or navigator. 
    • Our list of suggested questions to ask is different for different types of treatments. Feel free to print a copy of the following questions and take the copy with you to a doctor's appointment. 
    • If you would prefer to create your own list, you can keep track of your questions with our Prioritizer
      • Write questions as you think of them. 
      • Before you go to the doctor, you can number the questions in order of priority to you. 
      • A click of a key will shuffle your questions into the order you want. you can then print the form and take it with you.
    • NOTE: Do not worry that a question will sound "silly" or "strange" to your health care team. They know you want to understand your treatment plan.
  • Consider taking with you to each appointment where a potential treatment will be discussed:
    • A family member or friend to act as a patient advocate to help ask questions during the meeting and to discuss the answers afterward.
    • A recording device to record what happens during the appointment so you can review it later. (Many mobile phones include the ability to record.) You will also be able to play the recording for other concerned friends or family members. (NOTE: Ask the doctor if it is okay before recording the conversation.)
  • To be sure you understand the answers to your questions, consider the following. 
    • Repeat the information back to your doctor and ask if your understanding is correct. This is particularly imporant with respects to the risks, benefits and alternatives to a particular treatment.
    • If it would help you, ask the doctor to show you a visual such as an x-ray or scan provide or draw a diagram, or point you to an online video. 
  • If more than one treatment is available, after asking questions about each individual treatment, ask your doctor: "If you had a child of your own in my situation, what would you suggest he or she do?" Asking what the doctor would recommend to his or her child allows the doctor to express an opinion hypothetically which may lessen fears about liability that could prevent the doctor from giving an opinion.
  • If one treatment doesn't clearly fit your goals better than another one, consider using our Treatment Evaluator to help you make an informed decision.

Consent Forms: You will likely be asked to sign a Consent Form before treatment starts. Too frequently, the form is given when you are about to start treatment. It is preferable to get a copy of the form well ahead of any treatment so you have the time to read and absorb the information at your leisure. Medical consent forms are usually printed and look like they cannot be changed. However, you have the right to make any changes you want. For more information about medical consent forms, click here

If you want to refuse a treatment, but have difficulty saying so to your doctor, see How To Refuse A Treatment You Don't Want And How To Enforce Your Refusal If Necessary 

NOTE:

  • On a related subject, for information about how to choose a drug, click here.
  • If you haven't before, this is a good time to execute legal documents known as Advance Healthcare Directives so that if something happens, your wishes will be honored even if you become unable to communicate for yourself.  They are free and do not need a lawyer to execute them. 

To Learn More

Questions To Ask Before Agreeing To A Treatment

Ask the following questions for all treatments except surgery, chemotherapy or radiation which have questions unique to those situaitons. For those lists, click on the appropriate link.

  • What is my diagnosis?
  • What is the cause of the problem I am experiencing?
  • What is it that you are proposing? Please tell me in terms that I can understand.  Is there any written information I can read? If so, how can I get a copy?
  • What is the goal of the treatment? 
    • What are the chances the goal will be achieved?
    • Some clinical studies result in "clinical treatment guidelines" issued by a reputable medical organization. If there is such a guideline for my health situation, is the treatment within the guidelines? If not, why are you proposing something different?
    • Is the treatment based on clinical studies of what works best and what does not, or is it based on informed opinion, personal observation or tradition?  If based on a published study, if I want to look at it what is the study and where (and how) can I find it?
    • If the goal is to eliminate my condition, what are chances it will return?
  • What are the benefits?
  • How long will the benefits last?
  • What are the risks?
  • What are the alternatives? What are the benefits and risks of those alternatives?
    • What about clinical trials? (cutting edge treatments)
    • With respect to other treatment options, what are the benefits, risks and costs?       
    • Why do you recommend one treatment over another?
    • What is the cost effectiveness of the various treatments?
  • What is your reasoning for favoring this particular treatment?
  • If you are age 65 or over: Ask whether your age has anything to do with the recommendation. Some doctors have a bias against recommending certain treatments to older people, even though age has not been proved to be relevant.
  • How much experience have you had prescribing or performing the recommended treatment (for example, over how many years and how many patients)? What have your results been?
  • How long and how often will I have this treatment?
  • What will the effect be on my work? For instance:
    • Will I be unable to work at all? If so, for how long?
    • Will I need an accommodation to permit me to do my work? For instance, flex time so I can go to work late. Or time off for treatments or recovery?
    • How long will I need an accomodation?
    • How will I know if I am overdoing it at work?
    • Are you available to speak with my supervisor if that would be helpful?
  • If I take this treatment, are there other treatments that I will not be able to take in the future because I took this treatment?
  • How will we know if the treatment is working? How long will it be before we know?
  • Will the treatment be painful? If so, what can be done to control the pain?
  • Will there be other side effects? What can be done to prevent or minimize unwanted side effects?
  • How will the treatment interact with other drugs or treatments I may be using?
  • Will the treatment affect my daily life? If so,
    • In what way?
    • For how long?
  • How much will the treatment cost? 
    • Does my insurance cover the cost of treatment?  (If you do not have insurance, for information about getting care without insurance, see: Uninsured.)
    • How much will I have to pay out-of-pocket? 
      • When?
      • Can that amount be reduced?
  • Will the treatment prevent me from getting other treatments in the future?
  • "If you had a child of your own in my situation, what would you suggest he or she do?" (With a question stated like this, you can find out what the doctor thinks without putting him or her on the spot of seemingly being asked to make a decision for you.)
  • What would happen if I choose to delay treatment? To have no treatment at all?
  • Do you recommend that I obtain a second opinion from another doctor? If not, why not? (For information about obtaining second opinions, click here.)
  • Will I be asked to sign a consent form before undergoing the treatment? If so, can I get a copy now or at least before I have to make final decision? (Consent forms list all the risks of a treatment).
  • Do you have a financial interest in my decision, one way or the other?
  • Ask a "catch all" question such as "Is there anything else you would ask if you were me, or anything else that I should be aware of?"
  • If I do some research about the treatment and have additional questions, when can I ask them?
If you are a member of an HMO or other managed care health insurance plan, ask:
  • Does the insurer provide financial incentives for doctors to use a preferred treatment?
  • Is the doctor prohibited from informing you about treatment options other than the one or ones approved by the managed care company? This is a practice known as "gagging."  Gagging is supposed to be a thing of the past. However, it is still worth confirming that you have been advised of all of your treatment options.
  • Does the plan limit your doctor's choice to order treatments and make referrals if a patient's needs go beyond the plan's protocols?

If The Treatment Is A New Device

Be aware that the FDA approval process for a new device is not the same as for a new drug. The FDA approves new drugs as safe and effective. However, with respect to most devices, there is a fast-track review in which regulators simply determine if the device does what its maker says it does. The FDA does not determine whether the device is effective or whether it poses any undue safety risks. It also may be in the doctor's financial interest to recommend a new device since Medicare and many private insurers offer additional compensation to the doctor for using a new device on the theory that it takes time to learn about a new procedure.

If a new device is recommended, it is advisable to ask the following questions:

  • What is my diagnosis?
  • What is the device you are recommending?  
    • Do you have a sample to show me?
    • How does it work? 
  • What is the goal of using the device? 
  • What are the chances the goal will be achieved?
  • What medical evidence exists with respect to the effectiveness and safety of the device?
  • What are the alternatives?
    • If there alternatives, why do you recommend the one you recommend?
  • What will be the effect on my daily life? Work life?
  • Is there a financial incentive for the doctor to use the device?
  • What has the doctor's experience been with the device? (for example, number of patients and the results).
  • Does using the new device prevent me from other treatments in the future?
  • Is the device covered by my insurance?
    • If not, what is the least expensive way for me to obtain the device?
    • For additional information, see Uninsured.
  • Where can I find more information about the device?

If the device will be inserted by surgery, see: Questions To Ask Before Agreeing To Surgery

If you are a member of an HMO or other managed care health insurance plan, ask:
  • Does the insurer provide financial incentives for doctors to use a preferred treatment?
  • Is the doctor prohibited from informing you about treatment options other than the one or ones approved by the managed care company? This is a practice known as "gagging."  Gagging is supposed to be a thing of the past. However, it is still worth confirming that you have been advised of all of your treatment options.
  • Does the plan limit your doctor's choice to order treatments and make referrals if a patient's needs go beyond the plan's protocols?

If A Lifestyle Change Is Recommended

If a lifestyle change such as quitting smoking, limiting alcohol intake, losing or gaining weight, changing your diet or similar changes are recommended, ask:
  • What is the change you recommend?
  • What is the goal of the recommended change?
    • What are the chances that it will achieve the goal?
    • Over what period of time?
    • How will I know if it is working?
  • How much change is needed to make a difference?
  • What are the alternatives to make the recommended change?
    • What are the pros and cons of each recommendation?
    • Costs?
    • Are the costs insured?
    • Which would the doctor recommend?
  • What aides are there to help me make the change? For instance, are there counselors who can help? An app I can use on my computer or mobile device?
  • How can I find a support group or buddy in a similar situation?
If you are a member of an HMO or other managed care health insurance plan, ask:
  • Does the insurer provide financial incentives for doctors to use a preferred treatment?
  • Is the doctor prohibited from informing you about treatment options other than the one or ones approved by the managed care company? This is a practice known as "gagging."  Gagging is supposed to be a thing of the past. However, it is still worth confirming that you have been advised of all of your treatment options.
  • Does the plan limit your doctor's choice to order treatments and make referrals if a patient's needs go beyond the plan's protocols?

 

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