Let the patients make the decisions

I'm not sure why we continue to let insurers make decisions for us on our care. I completely understand that an insurer wants to keep an eye on expenses and want preapproval so they can count their beans. But they should not be telling us what care we can get - with in reason.

I agree insurers should not need to pay for cosmetic procedures for example. If someone wants to fix their nose, they can pay for it (through the nose). But decisions which relate to life and death care should not be theirs to make.

A new study showed that women on Medicaid are much more likely to have a mastectomy instead of a lumpectomy - 60% of those on Medicaid had a mastectomy vs. 39% of those with other insurance.

Or are the surgeons making the decision for the patient? The study also points out that surgeons are reimbursed 40% less for a lumpectomy than for a mastectomy from Medicaid. The surgeon should provide the information and the advice to the patient to make the decision but they should let the patients think for themselves, not the doctor's wallet.

The patient should make the decision - no one else.

Keeping up with the Jones'

If all your friends jumped off a cliff, would you? The latest fashion in breast cancer treatment is to have a mastectomy, even bilateral, at the least sign of breast cancer. The celebrities are doing it, so why shouldn't everyone else?

Because it doesn't necessarily mean the patient will have a better outcome. So why do patients opt for a much more drastic option when there is a significantly easier option?

The answer seems to be fear of recurrence. The professional reply is that 'No doubt, oncologists could do a better job calming women’s fears and educating them on the long and painful recuperation period involved with breast reconstruction following a mastectomy.'

Not so fast. I know many women who have gone through a breast cancer diagnosis who take time to think and make a rational decision that they really want two things:

1. Cancer out of their bodies
2. Not have to have such intense monitoring for the rest of their lives.

I do know some women who have not made as deep a thought process (like me) and did what the doctor advised. But many others have had a bilateral mastectomy for the peace of mind. Its not keeping up with the latest fashion.

Would you want to know?

I have blogged about this before. If you could do a genetic test to find out if you are likely to get an ailment and die of it, would you want to know?

I am still up in the air on this one. I was interested to read about a 21 year old woman who has the BRCA 1 gene, watched her mother die of cancer, but has decided she doesn't want to know. Her choice is to live an  unstressed like without the burden of the knowledge that she could die of cancer and what it would be like.

I can completely understand that point of view. Just because we can learn about our medical and genetic make up, do we have to learn it? I mean is there a benefit to living in ignorance and letting life happen around us with out having to learn what might or might not happen to us?

Why are we supposed to learn to see what the future brings? I have never been to a palm reading or a fortune teller or anything. I haven't really wanted to. Isn't it better to have life unfold as it may than to plan and learn and change ourselves to compensate for what we learn?

Hindsight in light is always 20/20 - we always look back and think back how we could have done better or differently or improved the outcome. But is it really to our benefit to think how we might have done things differently? Then we spend too much time ruing our decisions.

This would complicate my life immensely. If I knew then I would have too much time to over plan my life which would cause me to spend time ruing my decisions and over thinking everything.

I don't want to know.