Key words here are “educated patients”. This is a small but vocal minority. Most doctors love to have educated patients, but being confrontational and calling us “status-obsessed goons” does not help. I noticed how you found it important to mention your PhDd (both 11 and 12). Doctors don’t think they are perfect and know everything. We don’t claim to be statistical experts but make every effort to stay up-to-date (in fact we are required by law to attend CME) with relevant and well-supported research. Yes, we are aware that there are limitations and yes, we know that pharmaceutical-sponsoring is huge. Unfortunately, that is ALL we have sometimes.

I encourage my patients to read about their conditions and medications. Up-to-date has great patient handouts that I often print out for them. I think that most doctors welcome the “educated patient” but the line between “educated, empowered patient” and “arrogant, I-know-more-than-the idiot-doctor, entitled patient” is getting awfully blurry. Remember, the doctor also has exposure to many other patients and experiences that the patient doesn’t have. This goes a long, long, long way.

Finally, patient empowerment starts at home. It starts with taking care of yourself. It starts with diet, exercise, quitting smoking, etc. I am honestly sick of hearing the “I am the only one who cares about my own health. The doctors only care about keeping me sick” line from the obese smoker with COPD and uncontrolled diabetes snacking on Doritos and a regular coke in the room. I guarantee, I care more about that person’s health than they do. Is it paternalistic? Yes – it has to be. And the sad fact is that is the majority of the patients. I sincerely think that this is what is keeping the patient empowerment movement down.

My two cents – from someone who would gladly see an educated person concerned enough about their health to research it.

I learned the hard way to read the entire PDR entry on every new drug I take and discuss it thoroughly with both the MD and the pharmacist. I scour the literature. I now take responsiblity to educate myself and seek out second and third opinions until I can discover a consensus.

To be fair, I have found some MDs who participate and support me in this process. I freely admit the limits of my abilities and I do depend on the experts. I just wish more MDs would do the same.

I’ve also been appalled at the poor design or inappropriate statistics in some of the medical research (I have a PhD). I find many MDs are too busy to keep up with the latest literature and are not interested when I bring it to them. And now we find how often the pharmaceutical companies control the research and research reporting so that the literature may well be significantly incomplete and biased.

Clearly we need better communication and a partnership between open MDs and educated patients to reach the best possible outcomes.

Re peers: As a Ph.D. in stat, I am more than my doctor’s peer when discussing studies with a doctor. Indeed, I’m often appalled by the statistical ignorance of the average doctor. Other types of patients bring other types of expertise. Medical problems are simply not the exclusive domain of doctors.

Get real, docs. About 20% of your treatments do has any scientific validity. You make your money by manipulating fears of death and morbidity. You have bigger things to worry about than your “status.”

Kevin, it sounds just like that case you wrote about where the medicine resident didn’t order the PSA after having a long informed conversation with the patient. That was the definition of patient empowerment. And you see where it got all of them. Total joke.

I totally agree with you on the aspect a patient is not the same as your professional peer. I am a big proponent of those in the practice of medicine utilizing their peers more often to help come to a conclusion. There is always someone with a little more information or evidence on a particular item than we may hold ourselves. If a MD does NOT utilize his or her peers to seek out answers for a patient or the patient’s family, there is a huge problem with that particular MD.

The number of people, even among my own acquaintances, who do seem to believe this is a good idea is breathtaking.

Regardless of the establishment, there will always be those that will hold fast and be difficult to un-sway from their ideologies on what they think is right and wrong.

In every aspect of life, public safety is threatened every day. One of those things that will never change, the question in the field of health is how do those in the field open the minds of those un-swayed to realization that their perhaps one sidedness decision is not that of an informed decision. Evidence must be utilized in part of the informed decision making.

I totally agree with you on the aspect a patient is not the same as your professional peer. I am a big proponent of those in the practice of medicine utilizing their peers more often to help come to a conclusion. There is always someone with a little more information or evidence on a particular item than we may hold ourselves. If a MD does utilize his or her peers to seek out answers for a patient or the patient’s family, there is a huge problem with that particular MD.

Patients and their families are not peers but need to be included in the treatment, after all it is the patients health that is being dealt with and not that of the MD whom the patient is dependent upon for answers.

Their remains to be in society on all levels those that remain unopened minded, hence the continued issue with not making properly informed decisions for the benefit of their or their children’s health.

Just saying everyone, everyone, needs to approach everything with an open mind. The evidence must be included, that is if there is evidence to include.