April 10, 2017


Maximizers vs. minimizers: The personality trait that may guide your medical decisions - and costs (Laura Scherer and Brian Zikmund-Fisher, 4/09/17, The Conversation)

[I]magine two 50-year-old men who both experience chronic heartburn.

One is a maximizer who goes to the doctor and receives a prescription medication for his heartburn. At the same visit, he also gets a blood test that suggests that he should be taking a statin for his cholesterol, as well as a blood test to screen for prostate cancer that triggers multiple follow-up tests.

By contrast, the other 50-year-old man is a minimizer who does not go to the doctor when he feels heartburn symptoms. Instead, he adjusts his diet to address the problem. He does not end up taking any medications or getting any medical tests.

In our research, maximizers report that they receive more medical care than people with more minimizing tendencies. For example, maximizers take more prescription medications, visit the doctor more frequently, are more likely to get vaccines and blood draws, and have even had more overnight hospital stays in the past 10 years, as compared to minimizers. These associations exist even though maximizers do not tend to be sicker than minimizers and are just as likely to report having health insurance.

When there is a choice to be made between doing more versus doing less, maximizers will probably push for more, whereas minimizers will be satisfied to do less. Maximizers often opt for more active treatment interventions. For example, maximizers are more likely to say they would prefer surgery over physical therapy for treatment of back pain, or chemotherapy over palliative care for end-stage cancer.

Is it better to be a maximizer or a minimizer?

It might seem like people who receive more medical care will be healthier, because they take care of health issues before they become big problems. However, there is increasing evidence that a lot of medical care that people receive provides minimal benefit and can even cause harm.

Let's return to our two 50-year-old men. The maximizer might be better off because his heartburn symptoms and cholesterol levels are being actively treated. However, the minimizer might have improved his heartburn symptoms or even his cholesterol-related risks without chancing any side effects from medications. Moreover, research indicates that screening for prostate cancer often does more harm by leading to overdiagnosis - that is, diagnosis and treatment of cancers that will never grow or spread. Thus, the maximizer might experience a variety of physical and emotional problems related to his prostate cancer screening test that the minimizer simply avoided.

Both HSAs and National Health save money by tilting us towards minimization.

Posted by at April 10, 2017 6:43 AM