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Trisha Torrey

Is There Such a Thing as Too Empowered?

By November 29, 2010

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A video crossed my monitor - one that shows a so-called empowered patient being too, well, empowered.

And I'm just not sure how to react. Should I laugh out loud? Should I cringe? Should I be angry? or?

Let's begin with the fact that it's a video of puppets, one a doctor and one a patient. The patient has made an appointment with the doctor to see what can be done about the itch he has developed. While the doctor seems ready to issue a relatively simple diagnosis, the patient - who has very savvily explored possibilities on the internet - decides he has "epidermal necrosis." He asks the doctor to sign paperwork so the patient can participate in a clinical trial.

And the doctor signs it.

Should I laugh out loud? Should I cringe? Should I be angry? or?

On the one hand, it's good to see that a patient is trying to inform himself. On the other hand, anything taken to an extreme is - well - extreme. We've looked before at cyberchondria, that point at which a patient googles so much that she convinces herself that she has a dread disease or is dying. This is cyberchondria taken to an extreme.

To me, that's not even the biggest problem in the video. In fact, it's a ways down the list.

One bigger problem is that there is no partnership. This isn't the doctor and the patient collaborating. This is the opposite of the old model of the doctor telling the patient what to do. This is the patient telling the doctor what to do. It's just as bad as the patient who watches a TV commercial for a drug, and when the commercial says "ask your doctor" - the patient instead TELLS his doctor to prescribe the drug.

Another bigger problem is that when the patient tells the doctor what to do - the doctor does it. In the real world, there are a handful of reasons that happens, not the least of which is time. Since the doctor doesn't have enough time to talk to the patient about it, instead the doctor simply writes the prescription. In the case of the puppets in this video, it's similar - it's just that the demand is for a clinical trial. The biggest difference is that whomever is running the clinical trial would probably decide the patient didn't meet the profile, so the doctor knows his signature won't have a negative effect on the patient.

Yes, there's a lot wrong with this video. Perhaps the biggest wrong with it is that doctors across the world are nodding their heads saying, "Yes! That's what happens when patients spend too much time on the Internet!"

Don't let this puppet video represent you or your relationship with your doctor. Be aware of what happens when you leap to conclusions and when you don't partner with your doctor.

Learn a better way of having your internet cake and sharing it with your doctor, too.

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Comments
November 30, 2010 at 8:59 am
(1) Veronika Freeman says:

I used to work with a doctor that had many of the concerns you expressed. He said is was a feeling shared among doctors that if they did not write the script the patient wanted that the patient would go to a doctor that would.

These types of patients, to me, seem more “self empowered” than empowered (if empowered is to mean, “having the knowledge to share in decision-making and treatment discussions”).

self-empowered
Part of Speech: adj
Definition: deriving the strength to do something through one’s own thoughts and based on the belief that one knows what is best for oneself

If patients have the tendency to believe they know better than their doctors then they are the ones that are rejecting the need for conversation to occur.

You’re right, everyone has to listen – I will tell nurses when I make an appointment that I need to spend a bit more time with the doctor if I have questions so they can plan accordingly. I will also try to be the last patient before lunch or the last patient of the day sometimes.

Empowered is having the knowledge to be a partner in the treatment plan – not bullying the doctor into doing what the patient wants. But, doctors need to respect the patient’s knowledge and questions… which is new to many of them!

It’s like any relationship, there’s give and take and you don’t always get what you want (cause it just may not be what you need). But honesty, communication and trust are the keys to making it work.

November 30, 2010 at 10:28 am
(2) Dr. Patricia Arthur says:

Yes, Veronica, you are partially right in your analysis of the doctor/patient relationship. The most important part is the knowledge…..or lack of knowledge……the doctor might have for the many things patients desire. The Internet has an awesome collection of information, particularily for folks who want to take responsibility for their health and well-being. The doctor, on the other hand, doesn’t have time to spend hours and days in front of the monitor. Instead, what might have been a better approach to this scenario, would have been to ask the patient to bring in the information, for his perusal. Then make a collaborative decision relavant to the patients’ ideas. This way, the physician is learning, and the patient will feel as though they have an open and compassionate doctor interested in their welfare.

November 30, 2010 at 4:47 pm
(3) Susannah Fox says:

Please consider posting a comment on the Marketplace site so other people who see the video know that there is a discussion going on.

I posted a quick comment, just pointing out that I have *actual* survey data about the issues they highlight. Note: it took a few days and a few tweets to @MktplaceRadio to get the comment approved.

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