From our president: Choice words

We make a lot of comparisons here; gas vs. diesel, plasma vs. LCD, Ragú vs. Prego. So how about this: what people get from their health-care provider vs. what they actually want.

Consumer Reports asked more than a thousand people whether their provider listens; explains the options for treatment (including no treatment), the risks, and the benefits; and coordinates care. In all cases, "get" fell far short of "want."

The poll was part of a study by the Institute of Medicine and others on communication between patients and their health care providers (doctors, nurse-practitioners, and others). It confirmed that involving patients in medical decisions can lead to greater satisfaction, better understanding, and lower costs.

There has been a growing focus in the country on choosing tests and treatments that have been proved to be effective and that meet the needs and choices of individual patients. People rightfully want to share in setting the course of their health care, and they can do that only if they are given a clear, honest assessment of all of the options and the evidence behind them. Doctors are also increasingly conceding that there's no silver bullet, there's always risk, and the risk isn't discussed enough.

Further, the best medical care is coordinated among all of a patient's health care providers. With coordinated care there are fewer repeated tests, better and faster diagnoses, less chance of conflicting treatments, and lower costs. Yet fewer than half of the survey respondents said their health care providers work as a team.

Consumer Reports readers are among the most motivated consumers in the country. Sound medical decisions start with the goals and concerns of you, the patient. Ask your doctor to give you all of the options and the risks and benefits of each. Ask whether it's reasonable to do nothing at that moment ("watchful waiting"). If you leave the office believing you have only one option, your provider has fallen short. For more, go to iom.edu/evidence.