The age-old saying is that knowledge is power. But what happens when you are overwhelmed with the information you need to make a decision without the understanding of how that information fits together to answer your question? It’s like trying to put together a large, complex puzzle without a finished picture for comparison. Oh, and by the way, you also aren’t sure you have all the pieces. This situation can actually make you feel more confused and sometimes even powerless, but this is analogous to the current dilemma for patients in the era of health information overload.
Individuals, especially Millennials, are more and more aware of their health risks and want to take action to combat their problems. With increasing demands on time and other resources, the first place they will often go is the Internet to ask Dr. Google.” In a matter of seconds, one can input a list of symptoms or lab results and be fed a range of possible explanations ranging from hypochondria to a rare genetic disorder to occult malignancy. How are patients supposed to understand all of these options? How do we as physicians fit in and how are we supposed to help them make sense of it all?
I admit that the role of Google and other search engines in medicine is not something to be underestimated. As a clinician, I rely on online resources every day to help cross-reference what I’m looking at with what’s been described in the past. In this way, I can be more confident that when someone reads my report, they can also walk away with the same impression, without even potentially having the images in front of them. Admittedly, when I search for an entity online, more times than not, I have a probable diagnosis in mind. But for patients who don’t have the base of medical knowledge, the sea of choices can lead to a spiral of clicks that points them in the wrong direction … and fast.
As a physician, I know that I shouldn’t ignore the combined power of the health record and the Internet or its potential to help (or harm) patients. I believe the web can be a valuable resource — a road map to enlighten and inform. But as a physician, I must act as a guide to put ambiguous, and sometimes even frightening, test results into perspective. As a radiologist, I do this by incorporating recommendations into my impressions and providing the source material where those recommendations stem from. In this way, patients can feel confident I am practicing evidence-based medicine. Patients do not often come directly to me to discuss their care as this is often handled by ordering clinicians, but when I do have face-to-face interactions, if their findings are consistent with a specific diagnosis, I will write down the name of it, so there is no confusion, and I will also give them a list of reliable websites that they can access to learn more about it.
As clinicians in the era of information overload, we have a role to help patients navigate the plethora of incidental findings. We must explain, clarify and reinforce each piece of the health care puzzle. And when patients have questions or seem confused, we need to step back and develop new ways to reassure them of our confidence in the meaning of various test results.
Kerri Vincenti is a radiology resident. This article originally appeared in the American Resident Project.
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