Healthcare Decision-making

Healthcare mindset

Our attitude toward health care is shaped by various factors. If your family rarely visited the doctor, you may visit the doctor less often. Bad experiences, loathing to spending money on health, or being too busy also might cause you to use the health care system less frequently. Likewise, if you have had good experiences such as through screening catching an early cancer, or if your family historically utilized the health care system often, you may tend to go to the doctor more frequently.

According to Jerome Groopman and Pamela Hartzband, authors of the book "Your Medical Mind", people who go to the doctor frequently have a mindset of a "maximizer" and those who rarely go are "minimizers". The authors stress that it is important to find a doctor who honors your mindset when helping you make health care decisions.

There is no right way to utilize the health care system. People who are minimizers may go to the doctor too late when a disease may have been more easily cured by early treatment. Maximizers may subject themselves to the risk of unneeded testing and treatment. Each situation has pros and cons - it is important to understand this when you make your health care decisions.

One important consideration for maximizers is health care costs. In the United States health care system, doctors get paid more to do more – called fee for service. Although most doctors are ethical, the incentives in our health care system are geared toward providing more service. When you ask a doctor to do an unnecessary test, they are more likely to do it for fear of missing something or to keep you satisfied as a patient. The better approach would have been to present you with the data and educate you on why a test is not needed. In these days of high deductibles, you have to pay the first portion of this excessive testing which runs up your out-of-pocket costs.

Maximizers are also more likely to use holistic medicine such as acupuncture, chiropractic care, or herbal remedies. These are often not covered by insurance or only minimally covered. If this is your situation, you must consider these additional costs in your budget.

If you are a maximizer, consider your health care mindset when planning for health care costs in retirement. To reduce costs, make certain the tests and treatments you receive are based on evidence, that the outcome of the tests or treatments will make a difference in your health, and that you ask about less expensive options. Health care mindsets can be adjusted through education, patient empowerment, and a doctor who understands your needs. This can control your costs now and in the future.