The other day, I was on LinkedIn when I saw a cartoon posted by a physician making fun of bad, annoying patients who self-diagnose using "Dr. Google" before they visit their doctor. While the posting was clearly tongue-in-cheek, it points to a cultural divide that is likely to get a lot worse before it gets better.
The post, by a physician I know to be digitally friendly, reminds us that patients who put doctors to the test by wanting to participate in the process are still a major source of stress for clinicians.
But sooner or later, that will have to change.
Regardless of how doctors feel about it, the trend is toward sharing more information with patients. One major example of this is the OpenNotes project, a national initiative working to give patients access to visit notes written by their clinicians. While the number of clinicians who share their notes with patients still isn't large, influential institutions have begun experimenting with this approach. Those include the MD Anderson Cancer Center, where 84% of active patients have obtained access to the electronic records, Beth Israel Deaconess Medical Center, which is in the process of opening all clinicians' notes by the end of 2014, and Kaiser Permanente Northwest, which is providing nearly 500,000 members with online access to notes written by the clinicians.
What's more, patients are increasingly demanding that their own research be included in the process of care. These days, we have not only patients who search the web or standard sources like WebMD, we have a whole new class of empowered digital consumers who dub themselves "e-patients." An e-patient, a relatively new phenomenon, takes the process of self-empowerment through Internet use to a whole new level. These "internet patients" see themselves as equal partners with their doctors in the health care process, and to make that work, they gather information about the medical conditions both on social media networks and on websites.
Not only that, patients are increasingly being empowered to monitor their own health care through wireless devices and smartphones. Sure, consumer health and exercise monitoring is the big thing right now, with companies like Fitbit getting most of the attention from the media. But as PricewaterhouseCoopers research notes, the technology industry is bent on putting more health care power in patients' hands. For example, Samsung's new Galaxy S5 smartphone comes with a built-in heart rate monitor. And money is pouring into startups targeting digital health, PwC notes.
Then consider that consumers are being asked to bear increasingly large shares of their own health care costs. If those who designed high-deductible plans are right, this will create even more engaged consumers who take a primary role in their own health care and that of those they love. And this inevitably leads to patients who demand more information about the care they or their loved ones are getting, on a completely open basis. And they'll come to physicians armed with whatever data they can dig up from whatever resources they consider legitimate, particularly online sources.
While this may be painful for some, the reality is that the role of physician as counselor is evolving rapidly. Clinicians can scold the "bad" patients who try to make sense of things, or they can accept that patients expect them to move into a new, more collaborative relationship that empowers them with information and treats them like a partner.