[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:12.38,0:00:14.04,Default,,0000,0000,0000,,I am a neurosurgeon,
Dialogue: 0,0:00:14.62,0:00:19.10,Default,,0000,0000,0000,,and I'm here to tell you today\Nthat people like me need your help.
Dialogue: 0,0:00:19.31,0:00:21.36,Default,,0000,0000,0000,,And in a few moments, I will tell you how.
Dialogue: 0,0:00:21.36,0:00:25.46,Default,,0000,0000,0000,,But first, let me start off by telling you\Nabout a patient of mine.
Dialogue: 0,0:00:25.60,0:00:30.08,Default,,0000,0000,0000,,This was a woman in her 50s;\Nshe was in generally good shape,
Dialogue: 0,0:00:30.33,0:00:32.74,Default,,0000,0000,0000,,but she had been in and out\Nof hospital a few times
Dialogue: 0,0:00:32.74,0:00:36.52,Default,,0000,0000,0000,,due to curative breast cancer treatment.
Dialogue: 0,0:00:37.05,0:00:39.83,Default,,0000,0000,0000,,Now, she had gotten a prolapse\Nfrom a cervical disc
Dialogue: 0,0:00:39.83,0:00:42.30,Default,,0000,0000,0000,,giving her radiating pain
Dialogue: 0,0:00:42.30,0:00:45.100,Default,,0000,0000,0000,,of an intense kind out into the right arm.
Dialogue: 0,0:00:46.39,0:00:50.95,Default,,0000,0000,0000,,Looking at her MRI before the consultation\NI decided to suggest an operation.
Dialogue: 0,0:00:51.63,0:00:56.10,Default,,0000,0000,0000,,Now, neck operations like this\Nare standardized and they're quick,
Dialogue: 0,0:00:56.51,0:00:58.24,Default,,0000,0000,0000,,but they carry a certain risk.
Dialogue: 0,0:00:58.24,0:00:59.80,Default,,0000,0000,0000,,You make an incision right here,
Dialogue: 0,0:01:00.45,0:01:04.28,Default,,0000,0000,0000,,and you dissect carefully\Npast the trachea, the esophagus,
Dialogue: 0,0:01:04.52,0:01:08.09,Default,,0000,0000,0000,,and you try not to cut\Ninto the internal carotid artery.
Dialogue: 0,0:01:09.13,0:01:11.32,Default,,0000,0000,0000,,Then you bring in the microscope,
Dialogue: 0,0:01:11.32,0:01:14.80,Default,,0000,0000,0000,,and you carefully remove the disc\Nand the prolapse in the nerve root canal
Dialogue: 0,0:01:14.80,0:01:19.54,Default,,0000,0000,0000,,without damaging the cord and the nerve\Nroot lying only millimeters underneath.
Dialogue: 0,0:01:19.85,0:01:22.39,Default,,0000,0000,0000,,A worst-case scenario\Nis a damage to the cord,
Dialogue: 0,0:01:22.39,0:01:26.09,Default,,0000,0000,0000,,which can result in paralysis\Nfrom the neck down.
Dialogue: 0,0:01:26.24,0:01:28.63,Default,,0000,0000,0000,,Explaining this to the patient,\Nshe fell silent.
Dialogue: 0,0:01:28.63,0:01:29.80,Default,,0000,0000,0000,,And after a few moments,
Dialogue: 0,0:01:29.80,0:01:33.98,Default,,0000,0000,0000,,she uttered a few very decisive words\Nfor me and for her.
Dialogue: 0,0:01:35.31,0:01:39.14,Default,,0000,0000,0000,,"Doctor, is this really necessary?"
Dialogue: 0,0:01:41.65,0:01:44.84,Default,,0000,0000,0000,,And you know what I realized\Nright there and then?
Dialogue: 0,0:01:44.84,0:01:46.42,Default,,0000,0000,0000,,It was not.
Dialogue: 0,0:01:46.95,0:01:49.88,Default,,0000,0000,0000,,In fact, when I get patients\Nlike this woman,
Dialogue: 0,0:01:50.11,0:01:52.60,Default,,0000,0000,0000,,I tend to advise not to operate.
Dialogue: 0,0:01:53.12,0:01:55.61,Default,,0000,0000,0000,,So what made me do it this time?
Dialogue: 0,0:01:56.57,0:02:00.62,Default,,0000,0000,0000,,Well, you see, this prolapse\Nwas so delicate
Dialogue: 0,0:02:00.62,0:02:04.26,Default,,0000,0000,0000,,I could practically see myself\Npulling it out of the nerve root canal
Dialogue: 0,0:02:04.26,0:02:06.73,Default,,0000,0000,0000,,before she entered the consultation room.
Dialogue: 0,0:02:07.31,0:02:10.61,Default,,0000,0000,0000,,I have to admit it;\NI wanted to operate her.
Dialogue: 0,0:02:10.91,0:02:12.34,Default,,0000,0000,0000,,I'd love to operate her.
Dialogue: 0,0:02:12.66,0:02:16.89,Default,,0000,0000,0000,,Operating like this is, after all,\Nthe most fun part of my job.
Dialogue: 0,0:02:20.74,0:02:23.00,Default,,0000,0000,0000,,I think you can relate to this feeling.
Dialogue: 0,0:02:23.00,0:02:25.33,Default,,0000,0000,0000,,My architect neighbor says
Dialogue: 0,0:02:25.33,0:02:28.35,Default,,0000,0000,0000,,he loves just sit and draw\Nand design houses.
Dialogue: 0,0:02:28.35,0:02:31.23,Default,,0000,0000,0000,,He'd rather do that all day\Nthan talk to the person,
Dialogue: 0,0:02:31.23,0:02:33.52,Default,,0000,0000,0000,,the client paying for the house,
Dialogue: 0,0:02:33.66,0:02:36.39,Default,,0000,0000,0000,,that might even give him\Nrestrictions on what to do.
Dialogue: 0,0:02:37.34,0:02:41.61,Default,,0000,0000,0000,,But like every architect, every surgeon\Nneeds to look the patient in the eye,
Dialogue: 0,0:02:41.61,0:02:43.05,Default,,0000,0000,0000,,and together with the patient,
Dialogue: 0,0:02:43.05,0:02:47.16,Default,,0000,0000,0000,,they need to decide on what is best\Nfor the person having the operation.
Dialogue: 0,0:02:47.16,0:02:51.46,Default,,0000,0000,0000,,And that might sound easy,\Nbut let's look at some statistics.
Dialogue: 0,0:02:51.75,0:02:54.87,Default,,0000,0000,0000,,The tonsils are the two lumps\Nin the back of your throat;
Dialogue: 0,0:02:55.05,0:02:59.08,Default,,0000,0000,0000,,they can be removed surgically,\Nand that's called a tonsillectomy.
Dialogue: 0,0:02:59.36,0:03:03.35,Default,,0000,0000,0000,,This chart shows the operation rate\Nof tonsillectomies in Norway
Dialogue: 0,0:03:03.35,0:03:04.53,Default,,0000,0000,0000,,in different regions.
Dialogue: 0,0:03:04.62,0:03:09.78,Default,,0000,0000,0000,,What might strike you is that\Nthere is twice the chance that your kid -
Dialogue: 0,0:03:09.78,0:03:11.47,Default,,0000,0000,0000,,because this is for only children -
Dialogue: 0,0:03:11.47,0:03:15.07,Default,,0000,0000,0000,,will get the tonsillectomy\Nin Finnmark than in Trondheim.
Dialogue: 0,0:03:15.07,0:03:17.46,Default,,0000,0000,0000,,The indication in both\Nregions are the same.
Dialogue: 0,0:03:17.46,0:03:19.56,Default,,0000,0000,0000,,There should be\Nno difference but there is.
Dialogue: 0,0:03:20.83,0:03:22.35,Default,,0000,0000,0000,,Here's another chart.
Dialogue: 0,0:03:22.35,0:03:26.91,Default,,0000,0000,0000,,The meniscus helps stabilize the knee\Nand can be torn or fragmented acutely,
Dialogue: 0,0:03:26.91,0:03:29.41,Default,,0000,0000,0000,,typically during sports like soccer.
Dialogue: 0,0:03:30.77,0:03:32.65,Default,,0000,0000,0000,,What you see here is the operation rate
Dialogue: 0,0:03:32.65,0:03:33.99,Default,,0000,0000,0000,,for this condition,
Dialogue: 0,0:03:34.04,0:03:37.07,Default,,0000,0000,0000,,and you see that the operation rate\Nin Møre og Romsdal
Dialogue: 0,0:03:37.42,0:03:41.47,Default,,0000,0000,0000,,is five times the operation\Nrate in Stavanger.
Dialogue: 0,0:03:41.86,0:03:43.39,Default,,0000,0000,0000,,Five times.
Dialogue: 0,0:03:44.08,0:03:45.23,Default,,0000,0000,0000,,How can this be?
Dialogue: 0,0:03:45.41,0:03:47.98,Default,,0000,0000,0000,,Did the soccer players\Nin Møre og Romsdal play dirtier
Dialogue: 0,0:03:47.98,0:03:49.63,Default,,0000,0000,0000,,than anywhere else in the country?
Dialogue: 0,0:03:49.63,0:03:50.93,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:03:51.80,0:03:53.38,Default,,0000,0000,0000,,Probably not.
Dialogue: 0,0:03:54.22,0:03:55.97,Default,,0000,0000,0000,,I've added some information now.
Dialogue: 0,0:03:56.19,0:03:59.60,Default,,0000,0000,0000,,What you see now is the procedures\Nperformed in public hospitals
Dialogue: 0,0:03:59.60,0:04:00.65,Default,,0000,0000,0000,,are light blue.
Dialogue: 0,0:04:00.65,0:04:03.64,Default,,0000,0000,0000,,The one in private clinics is light green.
Dialogue: 0,0:04:03.64,0:04:08.18,Default,,0000,0000,0000,,There is a lot of activity\Nin the private clinics in Møre og Romsdal,
Dialogue: 0,0:04:08.18,0:04:09.37,Default,,0000,0000,0000,,isn't there?
Dialogue: 0,0:04:09.37,0:04:10.80,Default,,0000,0000,0000,,What does this indicate?
Dialogue: 0,0:04:10.80,0:04:14.77,Default,,0000,0000,0000,,Possible economic motivation\Nto treat the patients.
Dialogue: 0,0:04:14.77,0:04:16.00,Default,,0000,0000,0000,,And there's more.
Dialogue: 0,0:04:16.00,0:04:19.76,Default,,0000,0000,0000,,Recent research has shown\Nthat the difference of treatment effect
Dialogue: 0,0:04:19.76,0:04:23.16,Default,,0000,0000,0000,,between regular physical therapy\Nand operations for the knee,
Dialogue: 0,0:04:23.16,0:04:24.93,Default,,0000,0000,0000,,there is no difference.
Dialogue: 0,0:04:24.93,0:04:30.48,Default,,0000,0000,0000,,Meaning that most of the procedures\Nperformed on the chart I've just shown
Dialogue: 0,0:04:30.73,0:04:33.44,Default,,0000,0000,0000,,could have been avoided,\Neven in Stavanger.
Dialogue: 0,0:04:34.18,0:04:36.51,Default,,0000,0000,0000,,So what am I trying to tell you here?
Dialogue: 0,0:04:36.62,0:04:37.89,Default,,0000,0000,0000,,Even though
Dialogue: 0,0:04:37.89,0:04:42.06,Default,,0000,0000,0000,,most indications for treatments\Nin the world are standardized,
Dialogue: 0,0:04:42.06,0:04:46.46,Default,,0000,0000,0000,,there is a lot of unnecessary variation\Nof treatment decisions,
Dialogue: 0,0:04:46.46,0:04:48.37,Default,,0000,0000,0000,,especially in the Western world.
Dialogue: 0,0:04:48.37,0:04:51.44,Default,,0000,0000,0000,,Some people are not getting\Nthe treatment that they need,
Dialogue: 0,0:04:51.44,0:04:56.23,Default,,0000,0000,0000,,but even a greater portion of you\Nare being overtreated.
Dialogue: 0,0:04:56.23,0:04:58.97,Default,,0000,0000,0000,,"Doctor, is this really necessary?"
Dialogue: 0,0:04:58.97,0:05:01.91,Default,,0000,0000,0000,,I've only heard that question\Nonce in my career.
Dialogue: 0,0:05:02.04,0:05:06.38,Default,,0000,0000,0000,,My colleagues say they never heard\Nof these words from a patient.
Dialogue: 0,0:05:07.02,0:05:08.75,Default,,0000,0000,0000,,And to turn it the other way around,
Dialogue: 0,0:05:08.75,0:05:11.28,Default,,0000,0000,0000,,how often do you think\Nyou'll get a "no" from a doctor
Dialogue: 0,0:05:11.28,0:05:13.05,Default,,0000,0000,0000,,if you ask such a question?
Dialogue: 0,0:05:14.04,0:05:15.72,Default,,0000,0000,0000,,Researchers have investigated this,
Dialogue: 0,0:05:15.72,0:05:19.73,Default,,0000,0000,0000,,and they come up with\Nabout the same "no" rate wherever they go,
Dialogue: 0,0:05:19.73,0:05:21.48,Default,,0000,0000,0000,,and that is 30 percent.
Dialogue: 0,0:05:21.48,0:05:25.19,Default,,0000,0000,0000,,Meaning, three out of 10 times
Dialogue: 0,0:05:25.45,0:05:28.94,Default,,0000,0000,0000,,your doctor prescribes\Nor suggests something
Dialogue: 0,0:05:29.04,0:05:31.79,Default,,0000,0000,0000,,that is completely unnecessary.
Dialogue: 0,0:05:32.00,0:05:35.45,Default,,0000,0000,0000,,And you know what they claim\Nthe reason for this is?
Dialogue: 0,0:05:36.59,0:05:38.24,Default,,0000,0000,0000,,Patient pressure.
Dialogue: 0,0:05:39.25,0:05:40.95,Default,,0000,0000,0000,,In other words, you.
Dialogue: 0,0:05:41.53,0:05:43.72,Default,,0000,0000,0000,,You want something to be done.
Dialogue: 0,0:05:45.24,0:05:47.60,Default,,0000,0000,0000,,A friend of mine came to me\Nfor medical advice.
Dialogue: 0,0:05:47.60,0:05:48.84,Default,,0000,0000,0000,,This is a sporty guy,
Dialogue: 0,0:05:48.84,0:05:52.29,Default,,0000,0000,0000,,he does a lot of cross-country\Nskiing in the wintertime,
Dialogue: 0,0:05:52.29,0:05:54.12,Default,,0000,0000,0000,,he runs in the summertime,
Dialogue: 0,0:05:54.12,0:05:58.13,Default,,0000,0000,0000,,and this time he had gotten\Na bad backache whenever he went jogging,
Dialogue: 0,0:05:58.13,0:06:00.33,Default,,0000,0000,0000,,\Nso much that he had to stop doing it.
Dialogue: 0,0:06:00.33,0:06:01.50,Default,,0000,0000,0000,,I did an examination,
Dialogue: 0,0:06:01.50,0:06:03.45,Default,,0000,0000,0000,,I questioned him thoroughly.
Dialogue: 0,0:06:03.59,0:06:04.65,Default,,0000,0000,0000,,What I found out
Dialogue: 0,0:06:04.65,0:06:08.76,Default,,0000,0000,0000,,is that he probably had a degenerated disc\Nin the lower part of his spine.
Dialogue: 0,0:06:09.37,0:06:12.11,Default,,0000,0000,0000,,Whenever it got strained, it hurt.
Dialogue: 0,0:06:13.05,0:06:15.40,Default,,0000,0000,0000,,He'd already taken up swimming\Ninstead of jogging.
Dialogue: 0,0:06:15.40,0:06:17.56,Default,,0000,0000,0000,,There was really nothing\Nto do, so I told him,
Dialogue: 0,0:06:17.56,0:06:20.40,Default,,0000,0000,0000,,"You need to be more selective\Nwhen it comes to training.
Dialogue: 0,0:06:20.60,0:06:22.50,Default,,0000,0000,0000,,Some activities are good for you,
Dialogue: 0,0:06:22.50,0:06:24.33,Default,,0000,0000,0000,,some are not."
Dialogue: 0,0:06:24.83,0:06:26.58,Default,,0000,0000,0000,,His reply was,
Dialogue: 0,0:06:27.11,0:06:29.16,Default,,0000,0000,0000,,"I want an MRI on my back."
Dialogue: 0,0:06:30.96,0:06:33.17,Default,,0000,0000,0000,,"Why do you want an MRI?"
Dialogue: 0,0:06:33.39,0:06:35.97,Default,,0000,0000,0000,,"I can get it for free\Nthrough my insurance at work."
Dialogue: 0,0:06:36.44,0:06:39.44,Default,,0000,0000,0000,,"Come on," I said -\Nhe was also my friend -
Dialogue: 0,0:06:39.63,0:06:41.26,Default,,0000,0000,0000,,"that's not a real reason."
Dialogue: 0,0:06:41.47,0:06:45.97,Default,,0000,0000,0000,,"Well, I think it's going to be good\Nto see how bad it looks back there."
Dialogue: 0,0:06:46.64,0:06:49.97,Default,,0000,0000,0000,,"When did you start interpreting\NMRI scans," I said.
Dialogue: 0,0:06:49.97,0:06:51.37,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:06:51.78,0:06:55.22,Default,,0000,0000,0000,,"Trust me on this,\Nyou're not going to need the scan."
Dialogue: 0,0:06:56.35,0:06:59.50,Default,,0000,0000,0000,,"Well," he said,\Nand after a while he continued,
Dialogue: 0,0:06:59.69,0:07:01.86,Default,,0000,0000,0000,,"it could be cancer."
Dialogue: 0,0:07:01.100,0:07:03.29,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:07:03.64,0:07:05.70,Default,,0000,0000,0000,,He got the scan, obviously.
Dialogue: 0,0:07:05.97,0:07:09.57,Default,,0000,0000,0000,,And through his insurance at work\Nhe got to see one of my colleagues at work
Dialogue: 0,0:07:09.57,0:07:13.28,Default,,0000,0000,0000,,telling him about the degenerated disc,\Nthat there was nothing to do,
Dialogue: 0,0:07:13.28,0:07:15.86,Default,,0000,0000,0000,,he should keep on swimming\Nand quit the jogging.
Dialogue: 0,0:07:16.10,0:07:18.17,Default,,0000,0000,0000,,After a while, I met him\Nagain, and he said,
Dialogue: 0,0:07:18.17,0:07:20.36,Default,,0000,0000,0000,,"At least now I know what this is."
Dialogue: 0,0:07:20.74,0:07:22.58,Default,,0000,0000,0000,,But let me ask you a question.
Dialogue: 0,0:07:22.58,0:07:26.59,Default,,0000,0000,0000,,What if all of you in this room\Nwith the same symptoms had an MRI?
Dialogue: 0,0:07:26.59,0:07:30.61,Default,,0000,0000,0000,,And what if all the people\Nin Norway had an MRI
Dialogue: 0,0:07:30.61,0:07:32.78,Default,,0000,0000,0000,,due to occasional back pain?
Dialogue: 0,0:07:33.42,0:07:37.38,Default,,0000,0000,0000,,The waiting list for an MRI\Nwould quadruple, maybe even more.
Dialogue: 0,0:07:37.55,0:07:39.39,Default,,0000,0000,0000,,And you would all take the spot
Dialogue: 0,0:07:39.56,0:07:42.83,Default,,0000,0000,0000,,on that list from someone\Nwho really had cancer.
Dialogue: 0,0:07:42.90,0:07:45.81,Default,,0000,0000,0000,,So a good doctor sometimes says no,
Dialogue: 0,0:07:46.47,0:07:49.71,Default,,0000,0000,0000,,but the sensible patient also turns down,
Dialogue: 0,0:07:50.09,0:07:53.91,Default,,0000,0000,0000,,sometimes, an opportunity\Nto get diagnosed or treated.
Dialogue: 0,0:07:53.97,0:07:57.23,Default,,0000,0000,0000,,"Doctor, is this really necessary?"
Dialogue: 0,0:07:57.56,0:08:01.10,Default,,0000,0000,0000,,I know this can be\Na difficult question to ask.
Dialogue: 0,0:08:01.53,0:08:06.05,Default,,0000,0000,0000,,In fact, if you go back 50 years,\Nthis was even considered rude.
Dialogue: 0,0:08:06.94,0:08:10.93,Default,,0000,0000,0000,,If the doctor had decided\Nwhat to do with you, that's what you did.
Dialogue: 0,0:08:11.09,0:08:13.41,Default,,0000,0000,0000,,A colleague of mine,\Nnow a general practitioner,
Dialogue: 0,0:08:13.41,0:08:16.07,Default,,0000,0000,0000,,was sent to away\Non a tuberculosis sanitarium
Dialogue: 0,0:08:16.07,0:08:17.37,Default,,0000,0000,0000,,as a little girl.
Dialogue: 0,0:08:17.74,0:08:18.74,Default,,0000,0000,0000,,For six months.
Dialogue: 0,0:08:18.74,0:08:20.83,Default,,0000,0000,0000,,It was a terrible trauma for her.
Dialogue: 0,0:08:21.23,0:08:23.63,Default,,0000,0000,0000,,She later found out, as a grown-up,
Dialogue: 0,0:08:23.63,0:08:27.33,Default,,0000,0000,0000,,that her tests on tuberculosis\Nhad been negative all along.
Dialogue: 0,0:08:27.66,0:08:31.15,Default,,0000,0000,0000,,The doctor had sent her away\Non nothing but wrong suspicion.
Dialogue: 0,0:08:31.59,0:08:36.41,Default,,0000,0000,0000,,No one had dared or even considered\Nconfronting him about it.
Dialogue: 0,0:08:36.48,0:08:38.46,Default,,0000,0000,0000,,Not even her parents.
Dialogue: 0,0:08:39.37,0:08:42.65,Default,,0000,0000,0000,,Today, the Norwegian health minister
Dialogue: 0,0:08:42.65,0:08:46.15,Default,,0000,0000,0000,,talks about the patients'\Nhealthcare service.
Dialogue: 0,0:08:46.52,0:08:51.56,Default,,0000,0000,0000,,The patient is supposed to get advice \Nfrom the doctor about what to do.
Dialogue: 0,0:08:52.09,0:08:54.11,Default,,0000,0000,0000,,This is great progress,
Dialogue: 0,0:08:54.14,0:08:57.88,Default,,0000,0000,0000,,but it also puts\Nmore responsibility on you.
Dialogue: 0,0:08:57.89,0:09:00.65,Default,,0000,0000,0000,,You need to get in the front seat\Nwith your doctor
Dialogue: 0,0:09:00.65,0:09:03.20,Default,,0000,0000,0000,,and start sharing decisions\Non where to go.
Dialogue: 0,0:09:03.29,0:09:05.32,Default,,0000,0000,0000,,The next time you're in a doctor's office
Dialogue: 0,0:09:05.32,0:09:07.46,Default,,0000,0000,0000,,I want you to ask,
Dialogue: 0,0:09:07.90,0:09:11.32,Default,,0000,0000,0000,,"Doctor, is this really necessary?"
Dialogue: 0,0:09:12.22,0:09:16.88,Default,,0000,0000,0000,,And you might feel in many patients' case\Nthe answer would be "no."
Dialogue: 0,0:09:17.36,0:09:20.27,Default,,0000,0000,0000,,But an operation could also be justified.
Dialogue: 0,0:09:20.50,0:09:25.67,Default,,0000,0000,0000,,So doctors, what are the risks\Nattached to this operation?
Dialogue: 0,0:09:26.14,0:09:31.70,Default,,0000,0000,0000,,Well, five to 10 percent of patients\Nwill have worsening of pain symptoms.
Dialogue: 0,0:09:32.13,0:09:35.65,Default,,0000,0000,0000,,One to two percent of patients\Nwill have an infection in the wound
Dialogue: 0,0:09:35.65,0:09:39.94,Default,,0000,0000,0000,,or even a re-hemorrhage\Nthat might end up in a re-operation.
Dialogue: 0,0:09:40.81,0:09:44.17,Default,,0000,0000,0000,,0.5 percent of patients\Nalso experience permanent hoarseness,
Dialogue: 0,0:09:44.30,0:09:48.31,Default,,0000,0000,0000,,and a few, but still a few,\Nwill experience reduced function
Dialogue: 0,0:09:48.31,0:09:50.78,Default,,0000,0000,0000,,in the arm or even legs.
Dialogue: 0,0:09:51.00,0:09:53.84,Default,,0000,0000,0000,,"Doctor, are there other options?"
Dialogue: 0,0:09:54.10,0:09:56.48,Default,,0000,0000,0000,,Yes, rest and physical therapy
Dialogue: 0,0:09:56.49,0:09:59.94,Default,,0000,0000,0000,,over some time might get you\Nperfectly well.
Dialogue: 0,0:10:00.53,0:10:02.98,Default,,0000,0000,0000,,"And what happens if I don't do anything?"
Dialogue: 0,0:10:03.29,0:10:06.43,Default,,0000,0000,0000,,It's not recommended,\Nbut even then there's a slight chance
Dialogue: 0,0:10:06.43,0:10:07.73,Default,,0000,0000,0000,,that you will get well.
Dialogue: 0,0:10:07.77,0:10:11.00,Default,,0000,0000,0000,,Four questions, simple questions.
Dialogue: 0,0:10:11.00,0:10:14.13,Default,,0000,0000,0000,,Consider them your new toolbox
Dialogue: 0,0:10:14.13,0:10:15.71,Default,,0000,0000,0000,,to help us.
Dialogue: 0,0:10:16.19,0:10:18.12,Default,,0000,0000,0000,,Is this really necessary?
Dialogue: 0,0:10:18.12,0:10:19.58,Default,,0000,0000,0000,,What are the risks?
Dialogue: 0,0:10:19.67,0:10:21.29,Default,,0000,0000,0000,,Are there other options?
Dialogue: 0,0:10:21.39,0:10:24.82,Default,,0000,0000,0000,,And what happens if I don't do anything?
Dialogue: 0,0:10:25.22,0:10:29.36,Default,,0000,0000,0000,,Ask them when your doctor\Nwants to send you to an MRI,
Dialogue: 0,0:10:29.36,0:10:34.01,Default,,0000,0000,0000,,when he prescribes antibiotics\Nor suggests an operation.
Dialogue: 0,0:10:34.25,0:10:37.89,Default,,0000,0000,0000,,What we know from research\Nis that one out of five of you,
Dialogue: 0,0:10:37.89,0:10:39.24,Default,,0000,0000,0000,,20 percent,
Dialogue: 0,0:10:39.27,0:10:41.97,Default,,0000,0000,0000,,will change your opinion on what to do.
Dialogue: 0,0:10:43.12,0:10:47.85,Default,,0000,0000,0000,,And by doing that, you will not only\Nhave made your life a whole lot easier
Dialogue: 0,0:10:47.97,0:10:49.66,Default,,0000,0000,0000,,and probably even better,
Dialogue: 0,0:10:49.98,0:10:52.10,Default,,0000,0000,0000,,but the whole healthcare sector
Dialogue: 0,0:10:52.10,0:10:55.37,Default,,0000,0000,0000,,will have benefited from your decision.
Dialogue: 0,0:10:55.79,0:10:57.05,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:10:57.05,0:10:58.53,Default,,0000,0000,0000,,(Applause)