When Patients Know More Than Doctors

With a title like that, I know I’m bound to get a visceral response from some doctors, but hear me out. As someone told me today, the thing I love about John is that you know he’s going to tell you what he really thinks. He’s not going to hold back. Hopefully that’s true. Plus, I certainly welcome other people to provide opposing viewpoints so that we can all learn together.

First I should make it clear that I’m a great patient. I have extreme respect for the doctors I work with and follow their care plans to a T. For example, as a child I took accutane. That requires you to take pills twice a day. I think there may have been 1 or 2 times I missed taking my pills in 6 months. That’s pretty good if I say so myself. Regardless, I’m quite good at following the doctors care plan for me. Over time I have developed what I call a trust but verify approach. I trust that the doctor is doing what’s best, but I do like to confirm my understanding of why it’s being done when its a complicated situation. I don’t do this for things like common coughs and colds.

With this in mind, I was kind of blown away recently when someone told me about their 20 year old son who’s a diabetic. This patient and his parents had been dealing with his disease for about 15 years. As part of dealing with the disease they’d studied it and the various treatment and management options in depth. As he said, “we set a Google Alert and have read every study and discussion about the topic for 15 years.”

After moving, this diabetic patient went to see a new doctor who had just gotten out of medical school. A short discussion started and the patient quickly realized that he knew a lot more about his condition than his new doctor. What a challenging situation this must be for the new doctor.

I think most doctors are ok with this situation and have been dealing with chronic patients that know a lot about their disease for a long time. However, the availability of medical information is helping a lot of patients to be very well informed on their health issues. I wonder if a doctor use to treating well informed chronic patients has lessons we can apply to well informed general patients.

No doubt we’re in the stage of learning a new dance with a new partner. I’m not suggesting that we should change who’s leading the dance. The doctor should still be the lead for a lot of reasons. However, I am saying that the leader shouldn’t be surprised when their dance partner wants to provide some feedback on the choreography they’re doing. The leader might just find that working together they can produce even better results.

Side Note: It seems appropriate that I should use a dance analogy with the So You Think You Can Dance premiere tonight.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

8 Comments

  • Thank you for raising this issue. This should apply to nurses as well. And not just for chronic diseases. Many of us are well in tuned with our bodies and medical staff need to take that into consideration. A few years ago I was in the hospital for a THR in a well known and highly respected teaching hospital in Boston. Two days in, I knew that I had a significant fever. The nursing staff on this particular floor was beta testing a new thermometer device which was not working properly on me based on knowledge of the way my own body works. Until my fever shot up enough to register, they refused to believe I had one. At that point it was close to 103 degrees and still climbing. There were other things during this hospital stay that I had to strongly advocate for, like having the resident paged because the overnight nurse would not attend to excessive swelling from the surgery. I guess when I recount it, I’m still a little miffed. And hoping that this kind of thing will not repeat itself, but expecting that it has a good chance of doing just that.

  • An interesting but by no means an uncommon experience of a “know-it-all” patient Here we should be very clear that only the doctor has imbibed the ” horizontal” knowledge required to treat a patient as a whole and reading up on a single topic or disease does not make one an expert in the field! Just like an assembly plant worker who may be skilled in installing carburettors cannot be called an expert car mechanic!

  • Rajeev,
    It’s one thing to have a “know-it-all” patient and another to have a well informed patient. The first we all agree is annoying and a pain to have. The later needs to be accepted and incorporated into the care plan. The problem is that the later is often treated like the former.

    It’s funny you mention carburetor, because that’s one engine part that many mechanics will send you to see a specialist. The key is that it should be a collaboration between doctor and patient. Both sides have something to offer.

  • Interesting article, thanks for sharing. Not many years ago I published a weekly magazine, AutoTrader. Maybe you remember it. Well this magazine and the connected website gave used car buyers information. Lots of information. Many buyers had more information on cars than the used car dealers. At first the dealers struggled with such knowledgeable buyers. But overtime they adjusted and have come to learn working with the buyer is better than pushing cars on them.

    I believe healthcare in on the edge of a patient information explosion. mHealth apps will put information in the hands of patients, and if the doctors are sharp, they will want to share in that information too.

    Just saying!

  • John,
    Thanks for commenting. That’s a really interesting comparison. It does sound very similar to what we’re experiencing today in healthcare.

  • I think this is a situation that doctors do encounter, and should be aware of, but I agree with comment #2. While a patient may have read more on the topic of a particular part of medicine or a disease, unless they hold a doctoral degree in the life sciences, they have not been trained to understand the biology and chemistry of the human body, the body’s interaction with therapies, or even itself. Further, they have not been trained to be discerning about the articles published on a particular topic, or how to scrutinize published results.

    The doctor is trained in each of these areas.

    As such, the patient needs to realize that in terms of the overall biology of the human body, and the ability to decipher medical and scientific findings, the doctor’s training far exceeds their own. It behooves every patient to be respectful of the doctor’s ability and training to aid in their treatment/healing, after proper patient assessment and patient history review, which, by the way, doesn’t magically happen on visit #1 when you walk in the door.

    If you don’t have faith in the doctor you are going to, do some research on doctors available to you, and go to one who’s training you are confident is sound. You can also do this before ever going to a doctor, so that you walk in with confidence, and then meet with them respectfully and often so that they can get to know you, and work with you to best treat you.

  • Dr. Hoverman,
    Some great points. I think the title is a bit misleading. I’m not condoning disrespecting doctors or arrogantly saying you know more. I’m more just trying to illustrate that patients can provide value to a doctor as well. It’s not just all one direction (from doctor to patient). Collaboration and understanding are the key words.

  • “Trust but verify.” I guess that pretty much sums it all. Also, I think it’s a lot better if the patient, or anyone on the other end, is knowledgeable because then you won’t have a hard time explaining something that would otherwise be hard to explain to someone who has no single idea of what you are talking about.

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