One of the hardest things about being a patient is wondering whether the choices you’re making about your own or your children's health are the right ones. If a doctor offers you a treatment do you just say yes to it? What if you’ve heard bad things about a particular cream or really want to try a different approach? Do you even know all the different options available to you?
It can even harder if your doctor is giving you the choice of two or more different courses of action and you’ve no idea how to work out which is the right one for you.
The good news is that the NHS prides itself on empowering those who use its services to make good, informed decisions about their own care; patients do better when they are involved in making decisions and can make those decisions from an informed and ‘health literate’ position. This means your doctor is likely to encourage you to make decisions you’re happy with, and will answer your questions about the choices you’re facing.
So how do you make a decision about any treatment you’re offered for a chronic skin condition? Well, here are some points to consider about any treatment you’re offered, whether that’s emollients, steroid creams, phototherapy, immunosuppressants, nutritional support or anything else. It’s a simple and commonly-used series of questions that can help you get to the bottom of the whys and wherefores of your care.
Before you start, remember you have time to think about it. You can ask any questions you want to, and you have time to go home and read up about it if you need to. Unless it’s an emergency, you can sleep on it.
- BENEFITS Ask what are the benefits of this kind of cream or medication or procedure. What does it do? Why would it be a good thing to try? It’s important to get it clear in your head why you’re being offered this particular treatment over any other.
- RISKS Ask if there are any risks associated with the treatment. What side-effects are possible? Are there any reasons why someone might not want to use this particular medication? How often do people have problems with it and are they manageable ones?
- ALTERNATIVES What other options do you have, if you don’t take the medication or creams you’re being offered? Is there anything you could do instead, or try first? Do other people try other treatments? Are there cost considerations that affect which you’re offered? Could you try nutritional advice, allergy testing, life-style changes, herbal medicine etc., as well as, or instead of, what is being offered now?
- INTUITION This is a bit of an odd step, but it’s worth stopping to consider how you feel about the choice you’re making. Our gut feelings shouldn’t be the only or the most important input, into making a decision (you need to consider things rationally as well!), but it’s vital that you’re not just going along with something you’re uncomfortable with or that doesn’t sit right with you. There’s also good research suggesting that our unconscious plays a significant part in our decision-making process, even if you can’t quite articulate what is going on! So take a breath and listen to your gut. Express any worries you have to your doctor.
- NOT NOW… ? What would happen if you didn’t take the medication, the steroids, or the antibiotics you’re being offered? Again, this step is worth considering, just so you have the full facts at your fingers. What is the worst case scenario? What’s your doctor wanting you to avoid by taking this medication? Could you wait and see what happens for a set period of time or is treatment urgent?
These steps (which usefully spell out BRAIN!) are good for helping you make all sorts of decisions about your healthcare, not just for skin conditions. Whatever you decide in the end, going through each question carefully can give you the chance to understand what’s on offer, how it works, and what you can expect from it. Feeling empowered to make the right choices about your own health is hugely important!
After all, you’re the expert on your own body. You know what flares you up, what feels good and what doesn’t, and what you can cope with.
For more information about what options are available to people with eczema, visit the National Eczema Society.