Aging and Health Care Choices
By Hernán Drobny
There is a growing body of evidence in the medical literature indicating that active involvement by individuals in their own health care decisions leads to better outcomes and lower health care costs. This is the principle of “informed choice,” collaboration between the health care provider and the patient. For the patient, it requires preparation and clarity of what the priorities and preferences are. Getting old usually influences these priorities.
Lecture and Discussion
Aging and Health Care Choices: Preparing to Go Slow
By Hernán Drobny, MD
Fri, Jan 22, 2-3:30pm
Rinconda de la Aldea 29
The process of aging is well described. It is a normal part of life. Atul Gawande, in his book Being Mortal, titles his chapter describing the aging process, “Things Fall Apart.” The body declines with age. In the last portion of our life, we lose capacities and functions. We transition from independence to dependence. And then we die. The health care choices we make at this stage can have an important and lasting impact on the speed of this transition, in the quality of our lives and on the lives of our loved ones.
Yet making wise choices may run counter to the usual focus of standard medical care. The training of physicians is to fix by intervening. The chances of “fixing” the problem may be very low, yet we are urged to try. When we are old, future time may not be available to really benefit from the sacrifice these interventions may cause. Interventions also bring risks to our well-being and financial costs. Other options are available and supported by clinical studies.
The “slow food” movement led to the philosophy of a “slow planet.” This promotes quality over quantity, savoring rather than counting. The philosophy of “slow medicine,” which is gaining support in the care of the elderly, is an extension of this.
Perspectives and ideas on the influence of aging on health care choices from several respected physicians provide the framework for this presentation. Evidence supporting benefits of “slow medicine” will be described. There are surprising conclusions from clinical studies that you live better and longer when you stop focusing on life extension. How can we put this into practice?
Hernán Drobny, MD, taught and practiced Internal Medicine at the University of Michigan for 34 years. In 2002 he started one of the first consulting practices as a health care advocate by a physician. He wrote the book Your Health, Your Choice with the goal of enhancing the opportunity of each person to collaborate actively with their doctors. He lives in Ann Arbor, Michigan, and San Miguel de Allende.