What you don’t know can hurt you

CEBU, Philippines – I see the Internet as a way to pull back the deteriorating patient-doctor relationship. First of all, I believe that doctors like an informed patient. If you know something about your problem and I can talk to you at a more advanced level, then we’ve got a different rapport than we otherwise would have.

Second, the Internet actually empowers patients not only to take charge of their health but to be better patients and better decision makers. Any doctor worth his salt wants to make a decision for a patient – both diagnostically and therapeutically – in tandem with that patient, because a doctor who makes a decision with a patient automatically sets up a barrier to malpractice. If something goes wrong, it’s not, “You told me to,” and it makes a tremendous difference.

An informed patient, who is empowered by our new knowledge, also aids the doctor in the following way. Suppose that you called me as an old patient and said, “You know, I’ve been having pain in my chest today, and I think it is worse when I’m active, but, of course, it was after I ate.” Well, I make the judgment that you’re not in any serious trouble from what you’ve told me. I say, “I’ll see you at eight o’clock in the morning, and what I want you to do tonight is look up coronary heart disease on drkoop.com. Then when you finish that, look up gastro-esophageal reflux or GERD, and I’ll see you at eight o’clock.”

Right now in this country I’ll bet there are 5,000 doctors who are saying the same thing to a patient, “Your heart’s a pump and it’s got these two valves in it and all these vessels on the outside.” Well, if you had looked at the Internet, I don’t have to start at kindergarten level. I can start talking to you right away about angina, about unusable angina, about the choices one has in finding out if there is an obstruction. We can do this noninvasive technique, we can do an angiogram. If the angiogram shows an obstruction, we can do a cardiac bypass. The patient’s a graduate student to start with.

The Internet could also be a way of knitting together the frayed doctor-patient relationship. Let’s take your mother. She’s been to the doctor and she’s got a lot of questions that he didn’t answer because she’s on managed care and she had eleven minutes with the doctor. She’s home and she’s a little despondent, so she sits down and types a question and put in a word of comfort. She can read it and reread it and do whatever she wants with it, but it’s a connection with the doctor she never had before. It also saves playing telephone tag with your doctors.

—  from Fast Forward By Alfred C. Sikes with Ellen Pearlman (Morrow)