Well, yes – but…
Friday, December 19 2008
Pauline Chen, MD writes that patients should be more educated about their surgeons. She quotes Dr. Thomas Russell of the American Colllege of Surgeons.
“If we are truly going to reform the health care system in the U.S.,” Dr. Russell said, “everybody has to participate actively and must educate themselves. That means doctors, nurses, other health care professionals, lawyers, pharmaceutical companies, and insurance companies. But most of all, it means the patient.”
That’s a solid argument, but Chen’s column betrays an ignorance of the patient’s point-of-view.
When I look for a doctor, of course I am concerned about how that doctor relates to me as a patient. But there are a whole host of other issues I consider as well, such as the physician’s training, board certification, experience, membership in a respected professional society, safety records and hospital affiliations.
…as it turns out, most patients don’t feel the same way. And many of them are just as trusting when it comes to treatment specifics.
Chen assumes that because patients don’t do her kind of research, it makes them more “trusting” – ie not rational. I’ve already talked about the importance of social networks in making these sorts of decisions, but let me point out the assumptions Chen is making.
First, nearly everything she cites – training, certification, et cetera – is readily accessible for nearly any doctor. Why spend more than an hour on it?
Second, the really important stuff – safety and outcomes – is nearly impossible for patients to find. Please, somebody tell me if I’m wrong, but as far as I know this information is nearly impossible to come by except through unofficial channels. If Dr. Chen can get this info, it’s as another doctor – not as a patient.
Third and final: doctors don’t like to be challenged on this stuff – especially surgeons, in my experience. It’s all well and good to say patients should “come to the relationship educated about their doctors, their illnesses and their treatment”, but Dr. Chen has no clue what that process is like for a patient, and not a peer.
As a patient, you should be educated and informed about your illness, treatment, and physician. But this isn’t all on you, the patient. Your next surgery doesn’t require a master’s thesis worth of research. Instead, the doctors you already have should be helping you navigate this process – and doing a lot of that work for you. A good doctor will understand: it’s part of her job. Dr. Chen isn’t that doctor.
Hi, Duncan. I just found your blog and I love it. I wanted to point out that additionally a patient who does research about a condition and comes with questions is often accused of “getting a degree at Google University”. Can you imagine if we came in with questions about a surgeon’s record?
Welcome, hydropsyche! You’re right – and this is something that needs to change. Our health-care system needs more respect for self-empowered patients. Simply telling patients to do their homework won’t suffice if the doctors don’t change their attitude.
Good doctors should expect questions about their success rate.