Tuesday, July 22, 2014

Why some doctors are scared of Information Therapy


I recently had an interesting conversation with a senior doctor who was quite skeptical about the
value of empowering patients with information. He felt this was a fad, and would just create
more problems. He believed medicine was a complex subject – after all, it takes years of full-time training to become a surgeon, so how can one expect patients to understand the nuances of their medical problems in a few minutes? Isn’t it far better for them to trust their doctor, who is the true
expert, and who can help them heal quickly?

The doctor was very critical of patients who came with pages and pages of Internet printouts about
their medical illnesses. He felt they were often very confused and ended wasting a lot of their own time and his by wanting to discuss options and alternatives that did not make any sense. He also felt
that second-guessing just caused patients to doubt their doctor, and this loss of faith and trust would end up harming patients and doctors as well.

In general, he was quite dismissive about “well-informed patients” who felt they had become “half-doctors” by reading and researching their medical problem online. He believed a little knowledge can be dangerous, and patients who think they know a lot about their disease often created more problems than they solved by challenging their doctor’s decisions.

He also highlighted the fact that doctors, not used to having patients disagree with them, can often end up getting upset and angry with “well-informed” patients, which makes doctor-patient relationships confrontational rather than cooperative.

While everything he pointed out was true, this doesn’t mean there is anything wrong with the idea of information therapy. Like anything else, information can either be used properly or misused and abused.

The key is that the information we provide needs to be reliable, updated, evidence-based and tailored to each patient’s needs. If every doctor prescribed information rather than forcing patients to
seek it out for themselves, this would create a win-win situation. The patient would trust this information since it was coming from his doctor and would not have to waste his time wading through pages of potential misinformation. The doctor would also be more confident that the patient was well informed and had realistic expectations of his medical treatment.

WHAT IS INFORMATION THERAPY ?

Information therapy can be defined as the prescription of the right information to the right person at the right time to help them make better health decisions.

The ‘right’ information is accurate because it is evidence-based, approved by experts, up to date, easy to read and understand, available in many different formats (including local languages and audiovisual formats) and referenced.

The ‘right’ person means this information needs to be delivered directly to the patient (and their
caregivers). This information is best dispensed to a patient by his or her own doctor – the person they trust the most when it comes to their health.

The ‘right’ time means the information should be provided when the patient needs it – that is, in time
to help them make the best possible medical decisions.

So, what is the ‘right’ information, and who decides what is right?

ON THE RIGHT PATH

There are several ways of delivering this powerful tool – it can be clinician prescribed, system-prescribed, or consumer-prescribed. At present, most patients get information through their own research, often online where plenty of unreliable and misleading information exists.
Unfortunately, patients are often not knowledgeable enough to conduct searches that yield valuable results. In an ideal world, all relevant information would be routinely handed over to patients by doctors.

It’s a fact that hospitals and medical centres that systematically implement information-therapy
applications will be in a better position to gain market share, profitability and prestige over those
that don’t. It actually makes good business sense in a world where healthcare is rapidly evolving
around the world. We now have empowered consumers (who demand time, information, control, and service), a new focus on quality (which promotes safer medical care and a move towards
pay for performance), and a new way of validating what does and does not work in medicine (the science of evidence-based medicine).

Thanks to the Internet, we are also equipped with the technology needed to reach out to consumers
– it connects anyone, anywhere, any time to quality information.

These drivers create a compelling case for information therapy, which revolves around an expanded patient role. As healthcare evolves, the following should occur:
• Every clinic visit, medical test and surgery is preceded or followed by information-therapy prescriptions.
• Information prescriptions sent between in-person visits will extend the continuity of care.
• Patients will play an active role in shaping how they want information to be delivered to them.

Information therapy is a very cost-effective solution that allows a doctor to put each patient at the heart of the care he or she provides. As the renowned poet and writer Kahlil Gibran once said, ‘Progress lies not in enhancing what is, but in advancing toward what will be’.

In the delivery of excellent patient care, you and every one of the doctors in your practice should be prescribing information to each and every patient.


BACK TO BASICS

It’s important to remember here that the word doctor is derived from the Latin word docere, which means to teach or instruct. When doctors don’t do so, we are abdicating our responsibility and forsaking our patients, who feel lost and are then forced to fend for themselves.

The solution is simple – doctors need to guide their patients, and prescribing information therapy is a simple way of doing so. This must be curated, reliable information that both doctors and patients trust, thus ensuring they are on the same page and are active partners in a healing relationship.


This article first appeared in the Autumn issue of the Private Practice Magazine, which is published in Australia.


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