Saturday, June 27, 2015

Why doctors shy away from prescribing Information Therapy

I recently had a very interesting conversation with a senior doctor who was extremely skeptical about the value of empowering patients with information. In his opinion, it was no more than a fad which has the potential to open a Pandora’s Box of sorts.  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?

The Concerns

His words to me were- “Isn’t it far better for them to trust their doctor, who is the true expert, and who can help them heal quickly?” These were his concerns:

He 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 him
His belief was that this loss of faith and trust would end up harming patients and doctors too
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 that half 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 who aren’t used to having patients disagree with them, can often end up getting upset and angry with “well-informed” patients- this leads  to a confrontational rather than a cooperative doctor-patient  relationship

The Benefits

While everything he pointed out was true, it doesn’t mean that the concept of Information Therapy is incorrect and should not be encouraged. Like anything else, information can be used, misused and abused. In this  respect, doctors  can play a key role by ensuring that the information  they provide  their patients is reliable, updated, evidence-based and tailored to every patient’s needs. There are some distinct benefits to doing this:

If every doctor prescribed information, the patients wouldn’t find the need to look elsewhere  for it
On many levels, this would create a win-win situation. The patient would also trust the information as it was coming  from her  doctor and would not be inclined to scour  the Internet  for  clarification  or answers (most of which could  be potentially incorrect and inaccurate)
The doctor would also be more confident that the patient was well informed and had realistic expectations of his medical treatment
He would not get annoyed that his patients were trying  to challenge him, and he would be more  happy with  providing additional information and 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 her own doctor – the person she trusts the most when it comes to her 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

On the Right Path

There are a number of 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. As mentioned earlier, most of this is unreliable and incorrect.  It’s a fact that hospitals and medical centers that systematically implement Information Therapy applications will be in a better position to gain market share, profitability and prestige over those that don’t. 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.

Things that Should Happen

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 should be sent between in-person visits; this will extend the continuity of care

Patients 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”.

Back to Basics

It’s important to keep in mind 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.  We now have empowered consumers who demand time, information, control, service and a new focus on quality. The need of the hour is that doctors should guide their patients; and prescribing Information Therapy is a simple way of doing so.

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