Does more choice create better treatments?

I listened this morning to a wonderful TED talk by a Swarthmore College professor, Barry Schwartz, about freedom of choice. The central idea of this talk, as well as of his 2004 book The Paradox of Choice, is that more choice, instead of making us happier, makes us more miserable.
I could not help but think of this in correlation with Medicine and Pain Management in particular. Does the abundance of choice in terms of physicians and procedures, interventions, and surgeries make our patients better? These days, patients are assaulted from all directions by all sorts of “experts”, offering an immense array of choices for almost any condition. Has that improved our outcomes? Has that made our patients happier?
Schwartz also talks about expectations, and concludes that “happiness is about low expectations”, or, maybe more palatable for most people, “happiness is about realistic expectations”. This is also something we spend a lot of time talking to our patients about in our clinic. Sadly, we are in a minority. Most physicians are so pressed for time that they simply skip this fundamentally important part of any treatment: managing expectations.
I highly recommend spending a little bit of time watching this talk:


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  3. Public policy decisions frequently seem to be predicated on the presumption that giving consumers more choices, knowledge, and control over their decisions would result in better results. We analyze the psychology literature to determine why this "more is better" philosophy exists. Although educated consumer choice may lead to better results, we contend that having more alternatives, information, and autonomy may also have unforeseen negative effects. As examples, we mostly refer to health-related laws and regulations from the US and other countries.

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