Monday, February 28, 2011

Internet research and the Doctor-Patient relationship, Part 1

Recently, I was in the check-out line of my local supermarket, when the latest issue of Consumer Reports caught my eye. Though it’s a magazine I rarely read, the headline ‘What Doctors Wish Their Patients Knew’ made me toss it in my basket between the garbanzo beans and rice. As an advocate for closing the gap between doctors and patients in order to improve health outcomes, I eagerly wanted to read this issue. It’s lead me to write two articles this week on the topic of the patients’ Internet research, and how to get the most out of your relationship with your doctor.

The Internet has brought us many wonderful things, including emails from old friends, social movements, and out-of-print 7” inch records from early 80’s British bands. It’s also brought us a plethora of medically-related websites for consumers. According to surveys in this issue of Consumer Reports, 61% of patients did Internet research about their health, whereas only 8% of doctors said that Internet research by patients was very helpful. Exact figures are not important, but what’s indicated here is a conflict that sometimes happens in the doctor’s office.

While some doctors might wish that their patients lived under rocks without any access to medical information, I advocate for patient education and knowledge. That said, the Internet doesn’t always provide either education or knowledge, and sometimes it can be detrimental. What I’d like to outline here is how to use the Internet well to improve your healthcare.

To start, I’d like to address some of the reasons why consumers use the Internet in the first place. One of the primary reasons people turn to the Internet is because they want to understand more about their health  and don’t feel that their doctors explain them well enough. Part of the reason for this is the time constraints placed on physicians, time constraints that are an unfortunate product of the economics surrounding the practice of medicine. I recommend trying to find a physician who will take the time to talk with you, as they will be able to speak to the disease process and any specific issues that you are facing in a way that a website will not. For this reason as well as the next, finding a primary care doctor with whom you connect well is crucial to improving your healthcare outcomes. Most naturopathic doctors are more than happy to speak to you at length to make sure that you understand your health, and there are also a number of family practice MDs and internal medicine MDs who will do the same. If you do find that you need more information, I recommend using reliable websites to get more information about conditions, such as WebMD ( or Medline ( These websites will provide a lot of detail, though not all of it will necessarily applicable to you.

The other main reason that people utilize the Internet for health-related reasons is because they are not satisfied with the treatment options their doctor is giving them, and so seek alternatives online. Here things get a bit dicier. First and foremost, I would suggest that patients find doctors willing to explore alternatives. This doesn’t mean necessarily using ‘alternative medicine’, but rather doctors who will discuss various options within their own expertise. I find that most medical conditions have around 3 or 4 commonly accepted treatments, and naturopathic doctors may have an even broader range of options. If you do search the Internet for alternative treatments, discuss them with your doctor before starting on any treatment plan. This point is, unfortunately, a main one that separates doctors and patients – some doctors will not want to discuss alternatives, and may be dismissive of them. This fact ties back to my suggestion that you try to find a doctor that is willing to explore alternatives. Most naturopathic doctors will be aware of the range of alternatives, and can speak knowledgeably about them with you.

The other reason I say that this is dicier is because the Internet, like the Wild West, is full of medicine shows, and it’s sometimes difficult even for seasoned practitioners to determine their validity. Making things more complicated is that many of the products available on the internet are marketed as ‘cures’ for condition ‘x’. As I stated previously, there are often multiple potential treatments for any given condition, and in the world of alternative treatments in particular, the success of a particular treatment is very much dependent on your individual situation and your challenges. Thus, while a particular product may have worked for any number of people, it may not do the same for you. A good doctor should help you to navigate these murky waters. Bring the information to a visit, and make sure you have a good conversation about the pros and cons of a given treatment. Also try to find a second source on any information you read – WebMD usually has information about alternative treatments for conditions.

The take-home message is this: Your use of the Internet should improve your relationship with your doctor, not diminish it. The Internet is just a mass of data, and can be hard to navigate. Your doctor can help you sort the wheat from the chaff, and help you sort out which of the good information is applicable to you. It’s important to develop a strong working relationship with your primary care doctor, where you feel listened-to, respected, and understood. Likewise, it’s important to find a doctor whose opinion and judgment you value, as these doctors will best be able to help you navigate the complex field of healthcare options.

Look for part two of this article on Friday, in which I’ll discuss that bogeyman of the Internet, self-diagnosis.