Syndicom

Second, third, multiple opinions — E-patients and the democratization of healthcare

Susannah Fox, an associate director with the Pew Internet and American Life Project and founder of e-patients.net recently completed a research study focusing on e-patients and estimates that between 75% and 80% of Internet users have looked online for health information. More importantly perhaps, people who have a lot at stake, or who live with a disability or chronic disease as many spinal injury and disorder patients do, are more likely than any others to be serious online health researchers with 75% reporting that their last health search influenced how to treat an illness or condition they suffer.

Moreover, 59% of newly diagnosed e-patients reported using the information they had found online to ask a doctor questions and get a second opinion. 59% also shared the information they had found with others. More experienced e-patients, Fox found, post technical advice online, becoming health prosumers as they advise others on how to interact with their healthcare providers. And just in case you were wondering whether this information was helpful or harmful, 39% of e-patients say they or someone they know directly benefitted from the information they found online.

Clay Shirky states that now patients are “full-fledged actors in the system.” John Schwartz cites Dr. Talmadge E. King Jr., chairman of the Department of Medicine at the University of California, San Francisco in his blog, saying that in recognition of the more activated patient as a result of online research, he has found it “much easier…to look them straight in the eye and say, ‘I don’t know’ ” and promise to get back to them. Patients know you’re not all-knowing, he said. They’re not upset by that.”

Now that’s a radical shift in the expectations of a clinical relationship. As Matthew Holt, co-founder of the Health 2.0 conference suggests “the more people you have in the conversation, the better information drives out the worse information.” Dr Ted Eytan puts it this way, ““patients aren’t learning from Web sites — they’re learning from each other.”

But you know, all this talk of revolutionizing the patient-provider relationship assumes a particular power relationship between those who seek health care and those who provide it. In my own work on the clinical relationship, I have often taken the position that making sense of someone’s health is a interactive accomplishment between activated and informed partners. I have heard some question the ability or competence of a physician because they have consulted their peers. Frankly, as an educated consumer, I will do my homework online, find out what I can about a condition, what questions to ask and who to ask and I would hope my physician would do so too. In this way, both healthcare partners come to the conversation more informed, more respectful of the diverse forms of knowledge they each possess and more appreciative of the dynamic, evolving nature of such knowledge that belongs to the much larger communities of which these partners are members. The Internet notwithstanding, I think we have always had this partnering potential and sought it at a human level, especially when we put our bodies into the hands of others.

So physicians, fear not the e-patient, because they seek a sharing of knowledge with you. And patients, fear not the collaborative physician who partners with others, for they seek the very best care for you.

Together we rise.

With much appreciation for their aesthetic talent sent out to Robyn Gallagher and a.drian!

Kirsten Broadfoot