7 Responses

1. 

   Health 2.0 links for 09-22-08 | The eDrugSearch Blog

   September 22nd, 2008 at 4:20 pm

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   [...] Revolution Health: Heralding the Demise of “Health 2.0″? (Ted Eytan, MD) [...]

2. 

   Dr. Jesse Shantz

   September 22nd, 2008 at 8:48 pm

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   Having surfed around all the sites that are considered part of the health 2.0 revolution I think that this trend is here to stay, and evolve. Many physicians are sheltered from the benefits that sites such as patientslikeme.com and carepages.com give to patients and their families. As an orthopedic surgery trainee I think that I would rather have educated patients come to my office with specific questions and problems that require my assistance. Health 2.0 has the ability to not only relay medical information but also catalogue the patient experience, thereby allowing patients to make informed decisions even before they take a seat on the examining room table. Those sound like the kind of patients that I want to operate on!

   Jesse

3. 

   Ted Eytan

   September 24th, 2008 at 7:50 am

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   Jesse,

   Nice sentiment, especially from the surgical portion of our world! I hope (and believe) as more physicians encounter these patients they’ll realize that they’ll want to serve them as well,

   Ted

4. 

   Jan Swaney, M.D.

   September 24th, 2008 at 2:04 pm

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   As an internist with over 25 years of experience, I see the web as being a tremendous force that has democratized information, allowing patients/consumers access to what was previously known only to members of the club (profession.)

   This shift has been met with regret and resistance by some physicians who perceive it as eroding their professional authority, but it is clear is that this trend will not, cannot be reversed, and the challenge for the profession is to embrace the change and learn to renegotiate the doctor-patient relationship in the face of a more equitable sharing of information and power. We’ve talked for more than a decade about the importance of being patient-centered, so perhaps this trend will help us really move there.

5. 

   Ted Eytan

   September 24th, 2008 at 3:21 pm

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   Hi Jan,

   Thanks so much for commenting and sharing your experience as a physician with experience! Your post reminds me that I finally found commentary on “generational issues” that I am drawn to (e.g. that there aren’t as many issues as we’d like to think) and want to post here for others to look at. I almost think the regret and resistance doesn’t really exist except when people are asked to talk about regret and resistance, or at least that’s the thinking I’d like to carry with me about this – do you agree based on your relationships with other physicians?

   Ted

6. 

   Jan Swaney, M.D.

   September 24th, 2008 at 8:16 pm

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   I think the regret and resistance relates significantly to the perception that an informed and active patient may ask questions that slow down the visit, especially in instances when patients seem to have strayed tangentially in from an information path that might be considered mainstream. I remember a patient who, newly connected to the internet, became absolutely convinced that her occasional pedal edema was being caused by an infestation of worms.

   Its recall bias on our part: we are more likely to take note of and recall these encounters than we are the many visits that are more fruitful, engaging, and effective because our patients have (perhaps without or even knowing it) come prepared with a well considered list of questions or are more adherent to the recommended regimen due to the effort they’ve made to educate themselves.

   Jan

7. 

   Gilles Frydman

   September 25th, 2008 at 12:14 pm

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   Great comments, Dr. Swaney (or Jan from now on)!

   We definitely need more doctors like you around, particularly in these difficult times. Your last post is the first rational explanation of some of the resistance we have all been witnessing.

   As usual, the internet is held accountable for the facts that some people are misinformed, but I think a significant portion of the irrational patients would have been as irrational regardless of the techniques they use to build their medical house of cards.

   Since you clearly support the use of the internet how do you react when one of your informed patients becomes less adherent due to the effort he/she has made to become informed and hopefully educated about the medical condition they have to confront?

   Some studies do show a higher level of non-adherence in this population. And, as a very strong proponent of e-patients and participatory medicine, I am not convinced that the answer to this question is black or white. It is conceivable (probable?) that at least a portion of these non-adhering patients, in fact, know what they are doing. What do you think?