Friday, December 16, 2011

Side effects of Information Therapy

I am a big believer in Information Therapy. I feel that the more patients know about their medical problems, the better for them - and the better for their doctor as well !

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 just a new fad, and would just create more problems.

He believed that medicine was a complex subject – after all , it takes 8 years of full time training to become a surgeon ! 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 ?

He was very critical of patients who came with pages and pages of internet printouts about their medical illness. They were often very confused ; and ended wasting a lot of their time ( and his ! ) wanting to discuss options and alternatives which did not make any sense at all. He felt that all this second guessing the doctor just caused patients to doubt their doctor – and this loss of faith and trust in the doctor would end up harming patients - and doctors as well.

Hypochondriacs have a field day googling their symptoms. They end up with “medical student “ syndrome, convinced they have all possible medical diseases, ranging from asbestosis to
zoonoses !

He was quite dismissive about “well-informed patients” who felt they had become “half-doctors” by reading and researching their medical problem online. A little knowledge can be dangerous – and patients who thought they know a lot about their disease often created more problems they solved, by challenging their doctor’s decisions. Doctors are not used to having patients disagree with them – and often ended up getting upset and angry. This just damaged the doctor-patient relationship, making this confrontational, rather than cooperative.

Everything he said was true – but this does not mean that there’s anything wrong with the idea of Information Therapy. Like anything else, information can be used properly – or misused and abused. The key is that the information we need to provide patients needs to be reliable, updated ; evidence based – and tailored to the patient’s needs. Rather than force the patient to search for this information himself, if the doctor prescribed information himself, this would create a win-win situation. The patient would trust this information, since it was coming from his doctor and not have to waste his time wading through pages of rubbish. The doctor would also be more confident that the patient was well-informed and had realistic expectations from his medical treatment.

The word doctor is derived from the word, docere, which means “ to teach”. When doctors don’t do so, we are abdicating our responsibility and forsaking our patients. They feel lost and are then forced to fend for themselves – thus wasting their time , and their doctors’ time as well , because they need to clear up their patient’s confusion and doubts.

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

There is a difference between information, knowledge and wisdom ! If doctors prescribe information intelligently , they can trust their patients will become knowledgeable, and together they can create a wise path to help their patients navigate their illness.

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