Grand Rounds 44 is up at Pharyngula

Grand Rounds host Pharyngula, like me, doesn't feel like quite the inside medblogger, so the approach taken is kind of fun. Pharyngula tries to statistically represent what medbloggers take the time to blog about all week. Apparently 24% blog about training, while an equal number seem to blog about thinking/considering/ruminating about what they're actually doing.

Pharyngula points to two posts here, about my nephew with jaundice and my trouble asking the right questions when my cat was sick.

Pharyngula pulls out one of my quotes as an indicator of some concern, and I'd like to clarify:

The quote is: "…shouldn't the rates for doctors start to go down, since the Internet has alleviated the need for them to actually explain as much?"

Pharyngula's comment is: "I wonder if Google has encouraged more people to assume they know better than their M.D.s?"

My point is that patients have always had trouble extracting info from their doctors, sometimes cultural, sometimes understandable ignorance, sometimes doctors without time or intuition. Now patients have somewhere to turn to for info...but they still have to sift through lots of info and decide what's credible and applicable. If doctors were more forthcoming and more welcoming to questions perhaps we wouldn't need to be Googling or Wikipedia-ing "jaundice", but since they're not and we are...it seems like patients are taking on part of the job, and definitely expending more time doing their own research. And that will lower the perceived value of what doctors do, right?

Comments

[Nick]

I think you and pharyngula are pointing out different aspects of the same process. I think patient education is a big part of my job, but I know colleagues who wish patients would just sit quietly and get better.

Either way, the real value that doctors provide isn't knowledge, but rather judgement. Anyone, even computers, can match symptoms to diseases, diseases to treatments, etc. But you're paying for someone to make those calls for you.

That's why I hold my breath when I have a patient come in with internet printouts. It can mean they're motivated and curious (which is great, and probably improves outcomes) or they've already decided they have some bizarre rare disease and need my prescriptions.

In both cases, the value of my recommendations is still the same. But the patient-doctor interaction is more fruitful in the first case, and that will probably lead to better patient health in the long run.

[Bob]

Nick -

Have to agree with your assessment. Of course encountering someone who has already "solved" their problem via the internet is not just limited to the medical field. It extends to financial advice and other fields as well.

My observation is, more often than not, many have started with a premise, then found references to support their premise and are simply turning to professionals to sanction their conclusion.

In my field (financial services) I can simply dismiss them and hope that eventually they realize their folly and will genuinely seek out sound advice from a competent professional.

In your field (medicine) it is not quite so easy. Their mis-diagnosis can actually cause irrepairable harm.

An educated consumer can be both a blessing and a curse.