Over the last 50 years, the relationship between doctors and patients has changed dramatically. At a doctor's visit in the 1950s, you would probably walk in with a complaint and walk out with a prescription or a specific recommendation about what to do. It is unlikely that you would have asked many questions or challenged the recommendations. And bringing your own information about your condition to the visit would have been nearly unheard of!
Most people, including patients, their family members and health care providers, view these changes as a positive development: The days of physicians telling their patients what to do are fading fast, and none too soon. It is widely believed that informed consumers make better decisions and that doctors should welcome increasing patient involvement — after all, it is the patient, not the doctor, who must accept the health risks and benefits of any decisions made in the doctor’s office.
The Downside of Patient Empowerment
As with most rapid change, however, there are problems to consider. The notion that increased patient empowerment is always good is at least in part a myth. For example, it clearly matters how the "informed" patient (or consumer) becomes informed — incorrect, misleading or incomplete information abounds. While "information equals power" in many circumstances, if the quality of the information is poor, the doctor-patient interaction, as well as a patient's health, may suffer.
Optimizing Patient Empowerment
The age of patient empowerment is a welcome development and, hopefully, it is here to stay. However, the idea that it can only improve care is not true — there are pitfalls. Even so, the benefits of taking an active role in your health care can clearly outweigh the risks. Here are a few recommendations to make the most of patient empowerment:
· Ask questions when you see your doctor. Make a list of them before your visit; ask your health care provider if they accept or welcome e-mail — don't feel you have to wait for a visit to ask a question. Try to avoid hypothetical situations unlikely to affect you or trying to cover every possible contingency.
· Get a second opinion, especially if things are not going well, but avoid third and fourth opinions. At some point, more information does not make you better informed, it just overwhelms you.
· Get a primary care physician to coordinate your care and to look at the big picture. Even if your health care insurer does not require it, having a primary care physician can be a tremendous help, especially if you have several different problems.
· Be skeptical. Consider whether the source of your information has a vested interest other than your well-being. Avoid relying on sources of information that appear to be trying to sell you something.
· Stay informed by getting information from reliable sources: your doctor, academic medical centers, government agencies and professional medical organizations are good places to start. The web has great potential as a source of health information, but the quality varies widely. Look for information on the web that is accredited, affiliated with a reputable academic medical center, and does not push you to buy something.
Health Letter
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Telling Patients the Painful Truth
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