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?

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

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

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.

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

Jesse