Doctor Who? Are Patients Making Clinical Decisions?
ScienceDaily (Feb. 12, 2008) — Doctors are adjusting their bedside manner as better informed patients make ever-increasing demands and expect to be listened to, and fully involved, in clinical decisions that directly affect their care. In a study just published in Clinical Orthopaedics and Related Research, Dr. J. Bohannon Mason of the Orthocarolina Hip and Knee Center inCharlotte, NC, USA, looks at the changes in society, the population and technology that are influencing the way patients view their orthopaedic surgeons. As patients gain knowledge, their attitude to medicine changes: They no longer show their doctors absolute and unquestionable respect.
Demographic change, education, affluence, availability of information via the Internet, patient mobility, direct-to-consumer marketing, patient age, patient activity demands, cost pressures and physician accountability are converging to present the practitioner with a patient who is more informed and has higher expectations than any prior generation of patients.
Today's patients do not simply have a medical complaint, they desire a particular operation and sometimes even a particular implant. The doctor is no longer the sole source of medical information. Patients have enough snippets of information to stimulate a dialogue and clearly express their expectations for a particular outcome and technique to achieve that outcome. They are also demanding quicker recovery, return to higher-level sport activity and earlier discharge from the hospital.
"Patients have come to expect miracles in medicine as the norm, yet these miracles are not without inherent risk," cautions Mason.
Providing true patient-centered care relies on doctors' ability to supply patients with accurate, evidence-based information and to improve communication. However, patients are not necessarily motivated by evidence-based medicine. They are often willing to adopt the promises of direct-to- consumer marketing.
In Mason's view, the doctor's responsibility is "to maintain control of validated information sources and of the exchange of information with the patient. [Doctors] need to be interpreters and balancers of scientific information to help guide [their] patients through the maze of medical hyperbole. [They] need to discuss new treatments and technologies openly and honestly."
And crucially, they must also understand that although patients' demands are changing, the surgeon's accountability and responsibility for their patient's safety and care have not.
Journal reference: Mason JB (2008). The new demands by patients in the modern era of total joint arthroplasty. Clin Orthop Relat Res (DOI 10.1007/s11999-007-0009-2)
Adapted from materials provided by Springer.
4 comments:
These are some good articles, Susie.
It is so true. With the huge amount of information out there on the internet, we do turn to it to answer questions and self diagnose. Not always a good thing as it can lead to paranoia and over reacting to simple things, one thing leading to another and everybody thinks they have cancer lol...but can be a great tool for research as we've seen with the online support groups. People aren't so trusting any more and are not scared to ask questions to get the best treatment possible, it would be interesting to hear what these doctors/surgeons think of the subject, I don't think it is entirely a bad thing.
my experience with residents is that they grew up knowing and living this....so they are a little better at working with patients that are looking for answers on the internet. the older attendings have a more difficult time with this phenomena. the flip side though is that the older attendings are more willing to give up their free time and tend to be a bit more dedicated to patients (weekend call, etc) and the younger, newer residents don't want to deal with patient's after office hours...and of course this is the general, abbreviated version in a nutshell. you always have people that fall outside of this norm. just like everything with technology...so many growing pains.
soccermom
gee whiz...that post sounds so stuffy...like i was answering a question for class! :)
soccermom
I think that this can be a good thing as well as a bad thing. Some of the information on the internet is false, or, a patient will think a certain treatment relates to their condition and would like it, but in reality, this is not the condition they are suffering form. But, how many people with labral tears have been misdiagnosed by many doctors only to self diagnose on the internet, or some crazy chicks blog, only to be right? I guess it goes both ways. Most docs are willing to listen, even if you are a huge PITA about it (who...me??). And anyway, who was the one who said "you were right, I'm glad I listened to you".
As long as all parties involved can be respectful and professional, I think knowledge (can be) power!
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