Contrary to popular opinion, one of the main problems in providing uniformly excellent health care is not lack of money but lack of knowledge—on the part of both doctors and patients. The studies in this book show that many doctors and most patients do not understand the available medical evidence. Both patients and doctors are "risk illiterate"—frequently unable to tell the difference between actual risk and relative risk. Doctors often cannot interpret test results; patients cannot make informed decisions if they are given bad information. Surprisingly, treatments vary widely from one region to another. For example, in one referral region in Iowa, sixty percent of prostate patients had surgery, while in another region only fifteen percent had the same surgery. This unwarranted disparity in treatment decisions is the rule rather than the exception in the United States and Europe. All of this contributes to much wasted spending in health care.
The contributors to Better Doctors, Better Patients, Better Decisions investigate the roots of the problem, from the emphasis in medical research on technology and blockbuster drugs to the lack of education for both doctors and patients. They call for a new, more enlightened health care, with better medical education, journals that report study outcomes completely and transparently, and patients in control of their personal medical records, not afraid of statistics but able to use them to make informed decisions about their treatments.
About the Editors
Gerd Gigerenzer is Director at the Max Planck Institute for Human Development, Berlin.
J.A. Muir Gray is director of the National Knowledge Service, Oxford.
Health care needs an overarching goal that is shared by all stakeholders, and the one that is emerging is improvement of the value of care from the patients' perspective. This collection of papers from international experts explores the wide range of work that lies ahead, always thoughtfully and often brilliantly.
--Thomas H. Lee, Network President, Partners Healthcare System, Boston
This impressive series of position pieces is excellent and essential reading for all those seeking to promote patient involvement and improve patient experiences of health care. It brings together leading thinkers, planners, and implementers in the field, and as one would expect from the title is genuinely visionary--challenging patients, clinicians, policy-makers, and journalists to adapt to a rapidly changing world and ways of doing health care.
--Adrian G. K. Edwards, Department of Primary Care and Public Health, School of Medicine, Cardiff University