Is There Pressure to be Informed?

I recently had the opportunity to speak to employees of King County, WA about finding credible health information online. During the Q&A a few interesting questions were posed (rephrased here):

  1. Does my doctor expect me to have looked up my symptoms online?
  2. Does it help my doctor get to the diagnosis faster if I look my symptoms up online and come up with diagnoses, as well?

The person who asked question #1 told a story about reviewing some symptoms with his doctor at an appointment and being taken aback when his the doctor asked him, “And what did you find on the internet?” The patient had indeed looked up his symptoms online, and was surprised that his doctor knew. However, he was left wondering if he was actually expected to research his symptoms online before his appointments.

The second question is actally a good question that I had not considered but makes sense when looking at it from a patient’s perspective. Should patients do some “homework” prior to their appointments to help a doctor get to a diagnosis faster?

Regarding question number one, I often ask if there was something my patient thought he/she might have in order to make sure I address some concern that might be otherwise left unspoken during the visit. But I do not have an expectation that patients come in having “researched” their symptoms.

My answer to question #2 is based only on personal experience. It does not necessarily help me get to a diagnosis faster if a patient looks up his/her symptoms online. I have certainly had some patients who were able to come up with diagnoses that were correct. More often than not, though, the scenario in my office is one where a patient is concerned about the worst possible outcome (which, luckily, is not often the actual case). Then there are others who may have figured out their diagnoses but never mentioned it. As I do not have a well-studied answer to this question, I am open to hearing from physicians who might have had a different experience. That being said, I would not discourage a patient from using his own resources to find out more about his symptoms. However, he should keep in mind that after a detailed history (which is the part of the visit where the doctor gathers information from a patient’s story) and exam, the diagnosis could be very different depending on the actual details elicited and findings observed.

These two questions from the audience, however, brings to light our changing roles in healthcare. Certainly, the doctor-patient relationship has undergone yet another evolution with the concept of the e-patient, distant now from its paternalistic beginnings. But, in the midst of (at the end of?) the Information Age and, perhaps, heading into an “Understanding Age,” are there now new expectations placed on patients by others or by themselves?  Is there a certain degree of pressure to be an informed patient on those who may or may not be comfortable synthesizing this type of information? Is there an expectation that one knows everything about his/her own medical condition? Is there more pressure involved in just being a patient today? Sometimes, I think there is.

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