Statistics from the Pew Research Center indicate that the majority of people use the Internet to find information on health. As online resources improve and proliferate, this fraction will continue to climb higher. There is no doubt that patients see the Internet as one tool to learn about a condition, diagnose themselves, or read about the range of treatment alternatives. Patients understand that knowledge is power. So how should patients use this power in the exam room?
The answer to this question requires a bit of strategic thinking. Let’s first consider the worst- and best-case scenarios from my experience.
Worst case: A patient’s Internet research leads to unproductive debate on medically irrelevant topics and the entirety of the visit is spent trying to pry the patient away from his or her entrenched ideas. The patient leaves feeling unsatisfied, confused, and attacked. No clear diagnosis is made, and no treatment plan is formulated.
Best case: A patient’s Internet research leads to consideration of all possible alternatives, including some that the doctor may not have initially thought of. Having done her research ahead of time, the patient is prepared to ask more insightful questions that spur a higher-level dialog. The patient leaves having played a more active role in her treatment, and the doctor has maybe even learned something new.
Here are some tips and considerations to make your research-infused visit more like the best case.
1. Let it play out. In medical school, doctors are taught how to structure a patient visit. Per the teaching, it begins with open-ended questions and dialog, eventually narrowing to an assessment of the patient and a treatment plan. This is how doctors are accustomed to thinking and interacting. This is their comfort zone. To get the most out of your doctor’s considerable knowledge and training, it behooves you to keep your doctor in her comfort zone for the parts of the visit that are irreplaceable by online research: asking the right questions and conducting a physical exam. You are paying for the doctor’s mind and method. Allow them to earn that wage.
2. In the form of a question. When the time comes to unveil your research, use questions. “Before I came into the office I was looking online and was almost certain I had strep throat. What are you seeing that makes you think it’s not strep?” Or, “I understand we’ve been treating my headaches with these medications for years, why do you suppose we never considered this other medication?” It is important to remember that the objective is not to achieve those “gotcha” moments. The objective is to reconcile what you’ve been reading on the Internet with how your doctor wants to treat you. These questions should be aimed at uncovering the reason for the difference. Don’t leave without getting your questions answered.
3. Cite your sources. Never start a sentence with, “I read somewhere on the Internet.” Some sources are good, and some are bad. By citing your sources and bringing them to your appointment, your doctor can help you evaluate the source and the content simultaneously. One of the best ways to build credibility is to demonstrate your interest in assessing the credibility of your sources. The truth is that nearly every doctor uses Wikipedia or some equally dubious source at some point in his or her career. With training and experience, doctors learn to pull good information from bad sources and disregard the less important information in good sources.
4. Don’t be disheartened if your doctor doesn’t know everything. Being a doctor is about a commitment to learning. While some doctors may be more knowledgeable about one topic or another, almost every doctor is an exceptional learner. Make a plan to follow-up with your doctor if she needs more time to learn about the research you have done. Some of the best doctors I have ever worked with are less encyclopedic and more persistently curious. You want a doctor who feels comfortable saying, “I don’t know the answer to that, but I do know how to find the answer.”
With knowledge comes power, and with power comes the opportunity to use it strategically.
Victor R. Laurion is a medical student.