DOES ONLINE HEALTH IMFORMATION HELP THE PROVIDER-PATIENT RELATIONSHIP?

As a healthcare provider and a prescriber, I can say that overall I appreciate a well-informed patient who is actively involved in his or her health care. The fact that someone takes the time and makes the effort to try to learn about their health conditions or about preventive and wellness initiatives means that they have an interest in their health and that they will be willing to make an effort towards their own wellness. This can only make my job easier. I like to think of a patient-provider relationship as a partnership, not as a dictatorship. I can bark out all the orders I want and can write endless prescriptions, however a patient will not follow my directions unless they buy into and believe in what I am saying. I think that my job is to accurately and competently assess a patient, order the correct diagnostic tests and interventions, and then decide together with the patient about what the treatment plan will be. Of course I present the most current, up-to-date, evidence-based treatment options, but I will always discuss alternative treatments if a patient brings them up and will always take the time to listen to a patient if he or she has ideas gained from internet or other research. Afterall, the patient knows his or her body even better than I do.

As for direct to consumer pharmaceutical advertising: there have been many times when a patient has been unable to accurately describe symptoms to me or another provider, and then has gone home and heard a pharmaceutical advertisement describing a certain condition. As if a light bulb is turned on, the patient will say "that is exactly what I feel" or "that is what I have". When that information is again relayed to me, I find it to be very helpful. Oftentimes providers are not able to illicit the correct information from patients, either because we ask the wrong questions or we don't take the time to listen. The reverse side of this, of course, is that in some cases we have to be explaining to people why they don't have a certain condition or why they don't need a certain drug.

I don't feel that the abundance of information available on the Internet, on TV or in magazines gives patients too much control over their own treatments. As I've said, it can be a great help to have a patient walk in armed with some insight into their problems. It is then up to the provider to use good, sound professional judgment and to make all treatment decisions based on evidence obtained from current research studies and standards of practice, and to use that data to explain to the patient why a particular treatment may or may not be best for them. Patients want to get well or to stay well; they do not want to walk into the office and "get their own way". I feel that if a patient is insistent about a particular treatment which I don't agree with then I owe it to them to consider it and to present the facts and reasons why it is not the best course of action for them. I don't see that abundant health information is going to be harmful unless providers become so lazy and unethical that they stop communicating with their patients and just "give in" whenever a patient requests a certain drug. Although the provider-patient relationship should be a partnership, the provider is the one with the medical education and the professional licenses to treat and to prescribe, and the ethical duties involved in that must not be forgotten. Providers have a responsibility first to "do no harm" to their patients. This means taking the time to make the right decisions with the patient, not for him; it also means not becoming complacent and letting the patient call the shots and "get his way" because it is easier to do it that way. Practicing medicine is still going to be work; it's just that now we're dealing with a more informed patient population than before.