Friday, November 9, 2007

Google--Patient Empowerment or Patient Annoyance?

update (11/24): Dr. Haig's article, discussed below, has received a backlash of attention including this piece in the New York Times and this post by Dr. Val. Apparently, Dr. Haig touched many readers and bloggers, including Trisha Torry at Every Patient's Advocate and Matthew Holt at The Health Care Blog.

Dr. Scott Haig wrote an interesting article regarding patients who seem to have a little too much information at hand, "When the Patient is a Googler."

Every doctor knows patients like this. They're called "brainsuckers." By the time they come in, they've visited many other docs already — somehow unable to stick with any of them. They have many complaints, which rarely translate to hard findings on any objective tests.

So some patients can be rather difficult to deal with. However that is a truism for many human encounters. Some people are simply difficult and a series of unproductive experiences seem to further feed the source of that particular personality trait.

So Dr. Haig's experience with patient Susan got him "thinking about patients." He likes nurses who know the medical language and typically trust doctors. He likes engineers because "they're logical and they're accustomed to the concept of consultation — they're interested in how the doctor thinks about their problem."

If your orthopedist thinks about arthritis, for instance, in terms of friction between roughened joint surfaces, you should try to think about it, generally, in the same way. There is little use coming to him or her for help if you insist your arthritis is due to an imbalance between yin and yang, an interruption of some imaginary force field or a dietary deficiency of molybdenum. There's so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore.

"That one major responsibility of an expert is to know what to ignore."

I agree wholeheartedly!

"A seasoned doc gets good at sizing up what kind of patient he's got and how to adjust his communicative style accordingly."

I understand this concept well as it is something I do on an hourly basis with my students. One approach which works with 2nd-grader Susie may not be successful with 8th-grader Johnnie. Each student needs a personalized approach which still leads to the ultimate goal of developing a treasure chest of knowledge, experience, physical awareness, expressive control, and the problem-solving skills to enable the musician to become a self-sufficient interpreter of musical text and a creator of musical experience.

However, sometimes grand generalizations and assumptions can be misleading. Take for instance, the story Dr. Val relayed yesterday regarding a friend's painful experience in the ER, "The Benefit of the Doubt: Have Healthcare Professionals Lost It?" Sizing people up is a good skill to have, but not when the concerns of the patient are dismissed or neglected.

Doctors, please, trust your patient otherwise you feed their suspicions and distrust of doctors in general.

At the other end of our spectrum are patients like Susan: They're often suspicious and distrustful, their pressured sentences burst with misused, mispronounced words and half-baked ideas.

Today Dr. Val responds to Dr. Haig and tells us "Why Doctors Are Better."

Health information is more plentiful and accessible to patients than ever before. As a physician I am thrilled that people are empowered with knowledge to take control of their health, but I am also sincerely worried about the "misses:" misinformation, misconceptions, misdiagnoses and mistakes.

Information and knowledge alone are insufficient in deciphering the complexities of the human body and its reactions to internal and external stimuli. And with the growth of 'evidence-based medicine,' doctors are provided with, and hopefully contributing to, the collective science and knowledge regarding these complex physiological, chemical, emotional, cellular, and cultural interactions.

Google cannot remove the irrelevant, because it can't evaluate the science behind various claims, appreciate the nuances of an individual's life circumstances, or confirm a diagnosis.

The master sculptors in health information are physicians - trained for at least a decade in the art of analyzing data, appreciating the connectedness of various symptoms and body systems, and focused on chipping away at the irrelevant to uncover personalized solutions and cures - they are the artists whose experience and insight can make the difference between life or death.

... Information in the hands of a person who can apply it in an intelligent, personalized, and relevant way is our best shot at good, quality healthcare. There is an art to medicine, and the trick is to know what to ignore.

Once again I agree.

But, please!!

Do not ignore the patient.


  1. Amen, Lisa. You've made some excellent points about Dr. Haig's commentary on patients who google.

    It makes perfect sense to me that a doctor would not want to work with a patient who he feels is going to second guess him at every turn. That said, I also think he "read" the patient wrong. They didn't conflict because she had learned so much about her malady on the internet -- they conflicted because she was abrasive. That's her personality and not her background work.

    The real problem here, as I see it, is that Dr. Haig doesn't get that the patient is there for his expertise -- she is PAYING him for his expertise. She isn't there to put a smile on his face, or to feed his ego. She's not there to hang on his every word.

    She should be there to collaborate. Together THEY should find answers to help her.

    I think Dr. Haig has raised some good questions. I just think he needs to adjust his point of view to arrive at the real answers for problems that affect the doctor-patient relationship.

    Thanks for your post.

    Trisha Torrey

  2. Thank you Trisha for your great commentary. I appreciate the work you do to enhance the doctor-patient relationship, especially by empowering the patient to advocate for himself.

    To readers, if you haven't already, go check out Trisha's blog at EveryPatientsAdvocate/blog where she brings commonsense and humanity to the healthcare debate.