There’s no single right option in health care—there’s only the choice that’s right for you.

In July 2008, actress Christina Applegate made one of the toughest decisions a woman can make: She had a double mastectomy to help avoid the possibility of future breast cancer.

The 36-year-old Emmy-nominated star of Samantha Who? had cancer in just one breast, detected early by a health screening. But because she had a family history of the disease and also had tested positive for a gene linked to it, Applegate elected to have both breasts removed as a preventive measure.

Some women will feel at peace making such a decision, yet many others in the same situation would much rather live with a high risk for cancer than lose a healthy breast.

Choices You Can Live With
Everyone faces choices affecting their health, and far more often than they realize, according to Vicki Rackner, M.D., a board certified surgeon and clinical instructor at the University of Washington School of Medicine in Seattle. The choices often are not clear-cut, Rackner notes, and the decisions surrounding them tend to be highly personal.

Most of these choices aren’t earth-shaking like major surgery; rather, they’re the small stuff that can add up over time, with far-reaching health consequences.

“If you think about it, questions like ‘What am I going to have for breakfast? Am I going to hold onto a stressful grudge against a coworker? Am I going to take a 10-minute walk after dinner instead of watching TV?’ are important,” Rackner says. “I believe that at every moment of every day we make choices—choices that can lead in the direction of either health or disease.”

The core problem in health care, Rackner insists, is that people expect that there’s only one right choice— that the doctor will tell you the right operation and the right treatment for your breast cancer, for example.

Balancing Risks and Benefits
Rackner offers what she calls a “secret formula” for deciding what to do each time you’re faced with options surrounding your health.

Imagine there’s a scale on a table in front of you. Place the benefits of the first health care option facing you on one side of the scale, and the risks for that same option on the other side. Notice which way the scale tips: Are the risks heavier than the benefits, or is it the other way around?

Go through the same argument, weighing the risks and benefits for the next option facing you. Do this balancing act for each of your options; once you’ve done so, you’ll be able to more confidently make the best choice for you.

Weighing Decisions
For example, suppose you’ve been taking a cholesterol or blood pressure medication. Each day you choose to keep taking it, you may not notice any physical effect, yet your cardiovascular system is becoming healthier.

The risk might be a possibility of side effects. On the other hand, if you decide to stop taking the medication, you’ll have the benefit of less expense and no side effects—but a significantly higher risk for a heart attack

When it comes to quitting smoking, some people prefer to live with the risk for serious health problems because they like how it feels when they take a drag. But as they realize over time just how smoking affects not only their health but also their family’s health, they may realize the risks far outweigh the benefits.

If you have cancer and your doctor recommends chemotherapy, there’s a strong chance you’ll experience treatment-induced nausea and vomiting. If you feel the lifesaving benefits far outweigh the severe discomfort, you’ll go with the treatment. However, for some patients whose side effects are worse than any pain they can imagine, the treatment may not be the right answer.

“Ultimately, these are emotional decisions,” Rackner says. “The way the scales are balanced is different for every patient.”

Asking Good Questions
In order to adequately weigh risks and benefits, you need to know the ins and outs of all your options. This requires good communication with your doctor.

“This is all about making decisions you can live with,” says Rackner. “It’s not what your doctor wants for you, it’s about what you want for you. This is really about you, the patient.”

Polly Turner spoke with Vicki Rackner, M.D., a board certified surgeon and clinical instructor at the University of Washington School of Medicine in Seattle.

What the Research Says

Resources for Making Informed Decisions:

• The Web site of the Agency for Healthcare Research and Quality (AHR Q) makes it easier to make health care decisions. Visit www.ahrq.gov/questionsaretheanswer to build and print out a comprehensive list of questions you can ask your doctor on your next visit, based on the type of visit or health care decision you’ll be making.
• The MedlinePlus Guide to Healthy Web Surfing gives tips for safely researching medical conditions and comparing treatments online. Visit www.nlm.nih.gov/medlineplus/healthywebsurfing.html. It’s a service of the U.S. National Library of Medicine and the National Institutes of Health.
• The health risk assessments at Disease Risk Index shine a light on your personal risks for leading an unhealthy lifestyle—and the benefits of a healthy one. Visit www.diseaseriskindex.harvard.edu/update to learn your risk for diabetes, heart disease, stroke, osteoporosis, or any of 12 different cancers. The Harvard Center for Cancer Prevention created the site.
• Online rating services, such as www.leapfroggroup.org or www.healthgrades.com, can be useful when choosing between hospitals and doctors.
• The Personal Health Journal: A Resource for Owning and Directing Your Health Story, by Vicki Rackner, M.D., Medical Bridges, 2006, $39.95, is a place to store and organize your medical records while keeping a running account of your personal health story.
• The Web site of the American Academy of Family Physicians can help you assess your symptoms and determine if you have a medical emergency or a malady you can self-treat. Visit www.familydoctor.org and click on “Search by Symptom.”

© StayWell Custom Communications. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from StayWell Custom Communications.