Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Making poor choices by misjudging the level of risk

Steven Kussin, MD
Patient
August 5, 2012
Share
Tweet
Share

Risks are not certainties. They are the possibility that an activity will end badly. Risk is a handmaiden to almost everything we do.

Life itself is risky. Every decision is associated with the possibility of harm. Risk can’t be avoided, but it can be managed. Let’s talk today about the chances we take while living our everyday lives.

Risks are subject to a variety of misconceptions. What’s risky and what’s not is often a function of our personalities. Those who are risk averse put their money in the bank. Average risk takers may invest in a group of stocks rather than putting all their eggs in one basket. The risk takers will play the market and dabble in derivatives.

Risk averse? Take a nice walk in the woods. Average risk takers? Don cross country skis and glide through the woods. High risk takers will ski, barreling down the steep mountains in those woods. Those who are risk tolerant feel that, “Only those who will risk going too far can possibly find out how far one can go.” (T. S. Eliot). That’s fine for your pastimes but risky to your lifelines.

We are inundated with advice about risk taking. Much of it is wrong. More of it is silly. Sit back and think a bit. Are you a risk taker or will you avoid many of life’s pleasures to avoid taking chances. What’s your profile? Rise averse? Well the roofing repair career may not be for you. One in six are injured per year. And if you drive to your job the chances are 1 in 12 that you’ll have an accident this year, to boot. If you opted for a small car the chances are that the accident will leave you twice as likely to die than if you bought a large one.

We do many things by necessity. But a lot of what we do and the risks we take are choice. Based on your tolerance for risk, you might start asking questions about the risks of recommended tests and decide whether they are for you. A lot in medicine is elective. It’s here that choice rules. At the doctor’s office, you may decline the test whose risks are clear and immediate, however rare. This will be particularly true if the benefits are small, population based or play out far into the future.

Risk assessment

The rub is most of us are bad at judging risk. Our guesses about the magnitude of risk and the true dangers we face are often at odds. Even if we think we are being careful, we overestimate the risk of some activates and underrate the harms of others.

What’s the risk of dying from a heart attack? Most people guess about one in twenty. It’s one in three. A car accident? The perceived risk averages a guesstimate of about one in 70,000. It’s more like one in 7,000. That’s a 1000% magnitude of error. We land up protecting ourselves against the unlikely while failing to take precautions against activities that are more likely to harm us.

Planes, trains and automobiles

What is the safest mode of transportation? Nope, it’s not air travel. It’s intercitybus travel and streetcars.

Did you know that some observers think a couple of glasses of milk may be more dangerous than a couple of glasses of wine? Would you sooner walk along the street or fire up your Harley? No, again. It turns out you are twice as safe on the hog than on a jog.

Do you want to decrease your carbon footprint? Sure. We all want to save the planet and it doesn’t hurt that we are saving money too. When our homes are insulated and our wood fireplaces are burning we feel good. But it pays to know that the sprayed insulation material emits fumes that pose a health risk. And wood burning fireplace belches out carcinogenic particulate matter that becomes trapped in your now airtight home. Is it better that your home is green or that your face is blue?

Those who don’t want to take chances want to make sure everything in the baby’s room contains fire retardants. But the chlorinated Tris are known carcinogens. Long banned from your babies’ pajamas they are in almost every item in the nursery. It’s injury by fire today versus the chance of developmental problems and cancer later. It’s a tradeoff.

ADVERTISEMENT

“Sorry kids, no fireworks! Help dad set up the grill.”

Okay, but the chance of death and injury are far, far greater preparing the barbeque lunch than preparing fireworks’ launch.

Love foreign travel? You are aware of the far greater risks you take when placing yourself in the hands of pilots, planes, guides, strange neighborhoods, miscommunication and infectious disease than when at home.

But all those things are what you face in the medical system. And here, the risks are far more dangerous. You may not ever make a foreign journey, but you will someday go on a gurney journey. Risks are inevitable, but please let’s make them calculated risks.

You hop on commercial aircraft with barely a care. Would you set foot on that jumbo jet if you knew that one fell to earth every day killing all aboard? Not a chance. But 15,000 Medicare recipients die a month due to faulty care. Yes, you read that right. And that’s the equivalent of a packed commercial jet crashing a day. And that doesn’t include all the rest of the people in the country under 65. It doesn’t take into account the lesser injuries to the mind, body and wallet. Yet when you check into our offices and hospitals you are trusting. Why is that? It’s the false assessment of risk while in our hands.

When we misjudge the level of risk we can easily make choices that are ill-informed. We land up doing things and avoiding others, purportedly in the pursuit of health, only to find ourselves in even more peril.

Steven Kussin is a gastroenterologist and author of Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care. He can be reached at The Shared Decision Center.

Prev

Changing health care delivery at academic medical centers

August 5, 2012 Kevin 0
…
Next

My #USAToday column: Instant lab results require physician guidance

August 5, 2012 Kevin 0
…

Tagged as: Patients, Primary Care

Post navigation

< Previous Post
Changing health care delivery at academic medical centers
Next Post >
My #USAToday column: Instant lab results require physician guidance

ADVERTISEMENT

More by Steven Kussin, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Your consumer powers when choosing a hospital

    Steven Kussin, MD

More in Patient

  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How regulatory overreach is destroying innovation in U.S. health care

      Kayvan Haddadan, MD | Physician
    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • How regulatory overreach is destroying innovation in U.S. health care

      Kayvan Haddadan, MD | Physician
    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Making poor choices by misjudging the level of risk
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...