Friday, September 20, 2013

More Does Not Always Mean Better

Joseph A. Cincotta, MD

 Blog contributed by Dr. Joseph Cincotta, primary care physician

I grew up during a period when more or bigger seemed to mean better.  But, I have learned over time that this is not always true.  In fact, there are many examples of when more or bigger is harmful.  And, there are many examples in medicine when less is better and safer and healthier.  Unfortunately, this is a hard lesson to learn and it takes time to be embraced on a bigger scale in our community, our region, our state, and even our nation.

In the work I do it is not uncommon to be asked about the use of antibiotics or tests or procedures.  I need to work in partnership with my patients to find the best path when it comes to the use of medications, tests, and procedures.  Those decisions need to be based on a number of factors, one of which is what the accumulated evidence from carefully designed studies show about the effectiveness of medicines, tests, and procedures.  It is only through this type of critical and unbiased work that we will truly learn the benefits and risks of many different treatment interventions.  And, sometimes the evidence shows that NOT taking a medicine or doing a test or procedure is the BEST approach. 

An offshoot of this work is that we sometimes find we seek solutions in medicines or procedures instead of changing lifestyle habits and practices.  We are all inundated with commercials or information on the latest drug or test or procedure and encouraged to ‘talk with your provider’ to get this medicine or test or procedure.  And, many times the solution is not just in the medicine or procedure, but rather also in making some personal decisions for change.  This may mean a better diet, or some time to relax and meditate, or time to exercise, or a host of other healthy lifestyle changes that make a difference, do not cost anything, and have no bad side effects. 

So, the next time you start thinking that more is better, stop and understand that may not be the case.  Work with your primary care provider to find a path to better health based on evidence and a shared conversation about what is best for you.  You may find that it is less expensive, carries less risk for side effects, and helps you in ways beyond your immediate problem or concern.  We want to work with you as an active member of our health team to help you find the best path to health.  

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