What are my options? (Including wait and watch)
What are the possible benefits and harms of those options?
How likely are each of the benefits and harms to happen to me?
1. What are my options? (One of these options will always be wait and watch)
This question will encourage your doctor or nurse or other health professional to list the options you have upfront, so you have an idea of how many options there are.
There will always be at least 2 options, as one is always “wait and watch”.
2. What are the possible benefits and harms of those options?
This question asks your doctor to give you information about the different outcomes of the options you are considering.
If for example taking a course of antibiotics is an option, the benefits may include a quicker recovery, while the harms may include diarrhoea or nausea and vomiting.
3. How likely are each of those benefits and harms to happen to me?
This question asks for even more detail about the benefits and harms you now know about. What is the probability that you will experience the benefit or harms of the options?
The answer to this question will take into account things like your medical history, individual risk factors and lifestyle preferences.
Typical decisions in healthcare include whether to:
- Have a screening or diagnostic test e.g. a PSA (prostate specific antigen) test or a CT scan
- Have a surgical procedure e.g. total knee replacement
- Have a medical procedure e.g. colonoscopy
- Take medication e.g. antibiotics or betablockers
- Make a lifestyle change e.g. stop smoking, exercise regularly
- Start a health self-management program
What is wait and watch?
Wait and watch means keeping an eye on the problem and reviewing how you are feeling, or seeing if your symptoms get better or continue, at a later date.
This could be a few days, a few weeks, or a few months later; it all depends on what the health issue is that you are concerned about.
It doesn’t mean doing nothing, but it does mean that you and your doctor may decide that you don’t choose to start any treatment or have any tests at this point in time.
Where do these questions come from?
These 3 questions were developed by a team of people in Australia from a West Australian consumer advocacy program (Patient First Program), and a consumer health advice book Smart Health Choices* (www.sensiblehealthadvice.org). They are designed to prompt health professionals to provide information health consumers and patients need to make an informed choice between treatment options.
You may be thinking: “Why these questions?”, and “How do we know they work?”. In fact, a few years ago when these questions were first suggested and talked about on Radio National, a listener emailed the program and asked just that.
So in an effort to find out if the questions do work, we trained actors to sometimes ask, and sometimes not to ask, these questions of a large group of GPs. We found that when asked these questions, GPs gave better information about treatment options to the actor/patients and also encouraged the actor/patients to be more involved in the conversations they were having.
You can read about the study here **
* Irwig L, Irwig J, Trevena L, Sweet M. Smart health choices, Rev. and updated edition, London: Hammersmith Press; 2008, 256 p.
** Shepherd HL, et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Educ Couns (2011), doi:10.1016/j.pec.2011.07.022