Options in Medical Management of a Patient and Selection Process

Options in the medical management of a patient means there are various alternatives in the diagnosis and and treatment that may be considered and may be chosen.

In the medical management of a patient, there is no such thing as the one and only way of diagnosing and treating patients.   There are at least two options.  The number of options can be more.  The minimum is two options to chose from.

In the selection of a diagnostic procedure to be done on a patient, the various options should be listed down by the physicians.  The list of various options should include at least the ones commonly done in the community.  They may include the uncommon ones if needed for a comprehensive discussion and deliberation, especially if the patient volunteers an “option” information for consideration.    After the options are listed down, the physicians should offer information on how each diagnostic procedure in the list is being done.  They show also offer information on the respective and comparative advantages and disadvantages of their various options.  Essentially, comparative data and information on the benefit (diagnostic advantages), risk (side effects and potential complications), cost, and availability of the diagnostic procedure options are given.  These data and information allow the patient to make a choice.  The physicians can guide (not coerce, not force) the patients to make a choice, if necessary.  After the patients have chosen a particular option, the chosen diagnostic procedure is carried out.  This, in essence, is an informed consent.

The process for the selection of a treatment procedure option is essentially the same as that for the selection of a diagnostic procedure option.

In the selection of a treatment procedure to be done on a patient, the various options should be listed down by the physicians.  The list of various options should include at least the ones commonly done in the community.  They may include the uncommon ones if needed for a comprehensive discussion and deliberation, especially if the patient volunteers an “option” information for consideration.    After the options are listed down, the physicians should offer information on how each treatment procedure in the list is being done.  They show also offer information on the respective and comparative advantages and disadvantages of their various options.  Essentially, comparative data and information on the benefit (treatment advantages), risk (side effects and potential complications), cost, and availability of the treatment procedure options are given.  These data and information allow the patient to make a choice.  The physicians can guide (not coerce, not force) the patients to make a choice, if necessary.  After the patients have chosen a particular option, the chosen treatment procedure is carried out.  This, in essence, is an informed consent.






Illustrations – Selection from Diagnostic Procedure Options (or Paraclinical Diagnostic Procedure Options)

Once a decision is made that a paraclinical diagnostic procedure is needed, the next step is to choose the most cost-effective procedure for the patient by considering the various factors (tabulate, compare, and analyze):

Procedures Benefit (goal) Risk Cost Availability
Option1        
Option2        
Option3        

 


·         PARACLINICAL DIAGNOSTIC PROCESS – SELECTION – PROCESSING OF DATA – ILLUSTRATION 1

Procedures Benefit (goal) Risk Cost (PhP) Availability
Option1 most direct acceptable 1000 available
Option2 indirect acceptable 1500 available
Option3 indirect acceptable 1000 available

Which is the most cost-effective procedure? OPTION 1

·         PARACLINICAL DIAGNOSTIC PROCESS – SELECTION – PROCESSING OF DATA – ILLUSTRATION 2

Procedures Benefit (goal) Risk Cost (PhP) Availability
Option1 accuracy 99% acceptable 5000 available
Option2 accuracy 90% acceptable 3000 available
Option3 accuracy 50% acceptable 1000 available

Which is the most cost-effective procedure? OPTION 1 or OPTION 2 (depending on financial resources)

·         PARACLINICAL DIAGNOSTIC PROCESS – SELECTION – PROCESSING OF DATA – ILLUSTRATION 3

Procedures Benefit (goal) Risk Cost (PhP) Availability
Option1 yield > 90% acceptable 4000 available
Option2 yield  90% acceptable 4000 available
Option3 yield  80% acceptable 3000 available

Which is the most cost-effective procedure? OPTION 1






Illustrations – Selection from Treatment Procedure Options  

·         Selection of treatment procedure is based primarily on the pretreatment diagnosis.

·         Select the most cost-effective treatment for the patient after considering the various factors (tabulate compare, and analyze):

Treatment Benefit (goal) Risk Cost Availability
Option1        
Option2        
Option3        

 

·         SELECTION OF TREATMENT PROCESS – PROCESSING OF DATA – ILLUSTRATION 1

Treatment Benefit (goal) Risk Cost Availability
Option1 greatest surv rate acceptable 5000       available
Option2 rate < 1  > 3 acceptable 4000 available
Option3 least surv rate acceptable 3000 available

Which is the most cost-effective treatment option? OPTION 1

·         SELECTION OF TREATMENT PROCESS – PROCESSING OF DATA – ILLUSTRATION 2

Treatment Benefit (goal) Risk Cost Availability
Option1 survR1 =survR2 lesser 5000       available
Option2 survR2 =survR1 more 5000 available

 Which is the most cost-effective treatment option? OPTION 1

·         SELECTION OF TREATMENT PROCESS – PROCESSING OF DATA – ILLUSTRATION 3

Treatment Benefit (goal) Risk Cost Availability
Option1 as effective as 2 acceptable 8000       available
Option2 as effective as 1                acceptable 4000 available

 Which is the most cost-effective treatment option? OPTION 2

·         SELECTION OF TREATMENT PROCESS – PROCESSING OF DATA – ILLUSTRATION 4

Treatment Benefit (goal) Risk Cost Availability
Option1 most effective acceptable 2000       available
Option2 effectivity <1 >3 acceptable 3000 available
Option3 least effective acceptable 4000 available

Which is the most cost-effective treatment option? OPTION 1


 


other-options

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ROJ@17dec7

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