Thursday, September 07, 2006

Patient Empowerment

I read a very illuminating, and thought-provoking article, "The informed patient" by Dr David Tovey (Editorial Director of the British Medical Journal) in the September issue of the Singapore Medical Journal. He talks about “information therapy”, a term coined by Don Kemper of Healthwise to describe the prescription of knowledge by doctors to their patients to help them make better decisions about health care.

We doctors are so used to being purveyors of medical knowledge, that I am sure that I am not alone in admitting that when I used to encounter a patient armed with reams of information printed out from the Internet, my heart would clench a little with anxiety, and I subconsciously started to build a wall of resistance to this perceived challenge to my so-called authority!

But I have learnt that most of the time, these patients are only trying to empower themselves with knowledge so that they can understand their medical conditions or treatment. Those who are savvy enough to Google for information about their medical problem are usually able to understand that not everything can be believed and are open to a frank discussion on what information is reliable & what is not.

As human beings, we doctors can’t be expected to be all-knowing (we are not superior God-like beings after all, although some may think so - heehee!) of everything that is available on the Internet. There are thousands of bonafide medical studies & papers out there – as well as a kazillion websites full of quack info. I don’t think anyone in their right minds would expect us to read & memorize it all. What we can hope to do is to guide the patients & help them to separate the wheat from the chaff.

Websites* have been set-up from the UK & USA with information targeted at patients, explaining the condition, its treatment etc in language that non-medical persons can understand. Some even have a doctor/hospital finder.

We cannot ignore the fact that the Internet is a vastly used resource by many. I think we have to be ready to expect our patients to seek information therapy in addition to prescriptions from us!

* These are some examples. Some can only be accessed within its own country.
www.cochrane.org
www.webmd.com
www.healthwise.org
www.nhsdirect.nhs.uk/
www.besttreatments.co.uk/btuk/home.jsp

6 comments:

Anonymous said...

Yup, there's no need to feel threatened if you're confident that your knowledge is up to date.

On the contrary, we should assume all patients google their condition. i think this is a good thing, because you generally don't have to start from ground zero to explain their condition to them.

nofearSingapore said...

Hi,
I always encourage my patients to check around and even get second opinions about their conditions. I also caution them that in the net there are also a lot or rubbish ( but they already know this).
I feel angry when I know of patients getting less than complete advice from their previous specialists.
If the patient does not get a complete picture of his/her condition and suffers some side effect/complications, he is more likely to be a medico-legal problem later.
Those days of "I am your doctor so you treat me like God" is over!
Cheers
Dr.Huang

aliendoc said...

That's a great approach, Dr H, asking patients to get a second opinion. I think it actually adds to the trust they would have in your ability to manage them. This type of open communication between doctor & patient is SOOOO important to avoid potential complaints or medico-legal problems if any complications occur (touch wood!).

pretzel said...

Usually, i'd go to check at hospital/healthcare org websites like these to read up 1st:
http://www.mayoclinic.com/health/DiseasesIndex/DiseasesIndex

http://www.netdoctor.co.uk/diseases/


... sometimes can get more confuse/paranoid when can't differentiate the symptoms... so will check with Dr...

There's once i was sharing with this Spec re: a particular website written by a medical researcher relating to the specific condition. He was so impressed with the website, he even recommended to his other patients :)

aliendoc said...

pretzel: I think it is great that you do research into your own condition. More patients should attempt to understand more about their own health.

aliendoc said...

I wholeheartedly agree with dr Thiru's view that communcation is extremely important in order to have a good doctor-patient relationship. In a previous entry I wrote an open letter expressing what I think should be made clear to one's patient. I think most patient's are intelligent enough to understand it.

Thanks for dropping by!