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Possible vs. Probable

In the world of defensive medicine, in an attempt to absolve themselves of any liability, the corporate machinery of modern pharma and modern medicine bombards patients with all possible and impossible options, outcomes, risks, and adverse effects, "including death." You receive your bottle of pills, and it might come with several pages of risks, warnings, and a wide variety of adverse effects, even for commonly and widely used medications.

I am a firm believer in the power of patient autonomy and informed consent, but I do think it's my responsibility to make the information palatable and easy to understand so the best possible decision can be made.

Simply put, if I'm about to take a shower, is it possible that I might sustain a fall and serious bodily injury or even death? Yes, it is! Still, I take showers daily with complete confidence and without fear. Why? Because I believe that the probability of that kind of event is very low. Will it still be possible at my age of, say, 95 if I ever reach that age? Again, yes! But you already see where I am coming from; at that time, it will be much more probable that something like that might happen, and under these new circumstances, there might be hesitation to proceed without some help being nearby.

A reasonable question to ask is how one can decide without necessarily being in the field of medicine or having many years of experience with these matters. I think this is where us medical professionals need to step in and simplify the information, emphasizing what is realistically important, what you should seriously consider, and what, although possible, is not something you should be overly worried about.

Just as we do not necessarily plan our lives assuming we will get struck by lightning or win that lottery prize, even if we walk in the rain or buy that lottery ticket. But is it possible? Yes! Can it happen? Again, yes. It is really my job to know how the probability of an event changes with your unique personal characteristics, as well as to understand that for example treating a 30-year-old, a 55-year-old, or an 85-year-old person will not be the same. It is also my job to be aware of even the rarest possibilities and to recognize if this might be happening to you because, no matter what the 0.000 something % risk might be, if it happens to you, for you, it is 100%.

Again, even if it sounds like a cliché, it is most definitely true! Indeed, you are unique! One and only. What works for you is probably different then what might be working for someone else. Let's figure it out together.


Yours truly,

Milos Starovic, MD

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