How To Get The Best Service From Your Doctor

“The psychologist Gerd Gigerenzer has a simple heuristic. Never ask the doctor what you should do. Ask him what he would do if he were in your place. You’d be surprised at the difference.” ~ Nassim Nicholas Taleb, Antifragile: Things That Gain from Disorder

If you’ve been following this series, you know that running to your doctor for every little thing doesn’t make sense. And you also have an idea of when to seek their services. The decision about when to go or not is individual.

But when you do go to your doctor, there is a basic concept you should keep in mind. It goes by many names. One of the best is, “skin in the game.”

What do I mean by this? You need to be sure that the health advice you are getting isn’t biased by self-interest. Here are some examples of biased self-interest by doctors:

  • Doctors recommending treatments that they would never do themselves. See the quote from Nassim Nicholas Taleb at the start of this article. Remember to ask your doctor what he would do in your place.
  • Doctors recommending tests that their insurance company tells them they have to recommend. This can happen even if the situation doesn’t call for the test based on the doctor’s experience. And there are tests (PSA, cholestrol) where the results don’t give useful information.
  • Doctors getting paid by drug companies to prescribe expensive drugs. The technical name for this is “conflict of interest.” These payments aren’t always money, they also get trips and other perks. If you want a good example of this, watch the video linked below. It is a TED talk by an MD who faced this problem working with other doctors treating her mother for cancer. (Click image to watch):

Taleb, in his excellent book, “Antifragile,” calls the above kinds of conflicts the “agency problem.” It refers to people watching out for their own interests above the interests of their clients / patients.

He even quotes an old saying, “No doctor derives pleasure from the health of his friends.” I think this quote is not universally true, but it does point at the self-interest part of medicine.

The bottom line is you only want to go to a physician who “eats his own cooking.” If he wouldn’t follow his own advice, why should you?

Next week, you’ll learn a different way to approach health care. It’s about creating optimal health. Look for it next Monday.

All the best to you for your health and happiness,

Dr. Bruce Eichelberger

Dr. Bruce

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