There are certain situations in my life where I feel really stupid. One is when CNBC’s Squawk Box senior economics reporter Steve Liesman discusses the bond market. While I recognize the words he uses as English grammar, I find almost every word to be incomprehensible gibberish. Recently, he informed me that “given the Feds propensity towards quantitative easing in Q4 the 10 year yield could hit 3%.” I think that has something to do with money, and I have a suspicion that it might be important.
Another situation in which I am humbled and forced to recognize my own ignorance is when I get my oil changed. I know nothing about cars. It’s just not my thing. About half way through the visit the mechanic comes out with this round thing in his hand. He tells me it’s an air filter. He also tells me based on my past record at the Jiffy Lube that I am due to have it replaced. I realize that I do not know the current recommendations for air filter maintenance on a Jeep. While examining the filter with the mechanic I am unable to determine if the level of grime meets the criteria for replacement. Being totally honest, I am not even sure it is really an air filter or even a car part.
I am ok with this. I don’t have to know these things. We all have our areas of expertise, and there is nothing wrong with having to rely on others to get through life. Before spending the money though, I Googled the current recommendations for air filters. This was easily accessible material. It verified that based on my past history I was due for a replacement in the near future. This research helped guide my decision making. There was no misconception that I knew more than the mechanic. I used the information to ask better questions and to navigate through an area in my life in which I am uncomfortable. Ultimately, I made the decision based less on my research, but rather in my trust and confidence in the advice of the mechanic.
For patients, a doctor visit can feel like I did at Jiffy Lube. A patient is placed in a situation where there is a profound knowledge gap. As a doctor who believes in the power of online patient engagement, I am torn. I want my patients to educate themselves online. I want my patients to read, to learn and to educate themselves online. But I have seen patients fall into the trap of the Dunning–Kruger effect — believing they know and understand more than they actually do. The Dunning-Kruger effect demonstrates that people overestimate their ability and knowledge when exposed to a subject. This can be dangerous when dealing with health information.
Health information is widely available online. In a simple Google search one can find a plethora of information on virtually any health topic. The problem is that health information is unsorted and often unvalidated, and thus hard to interpret in order to take action. Information can be very helpful in some cases. But in other cases it can be anxiety producing at best and at worst flat out wrong.
Researching health information is very important, but we must recognize our own limitations. Understanding health information is hard. Science is complicated. Scientific studies often contradict each other. Health questions often just beg more questions, not always definitive answers. For every topic we Google and read about there is a likely a PhD who makes a living researching that one question every day. While studying on our own we must also value and respect health professionals years of studying, expertise and experience.
My advice to patients is to continue to use the Internet as a supplemental tool to augment the provider-patient relationship not as a wedge to hinder it. Use the Internet to improve your baseline knowledge, to ask better questions, to create a higher level conversation and to better understand the recommendations.
Recognize the content you read may just be the tip of the iceberg and acknowledge your limitations. Ultimately, use your research to help determine your level of trust and confidence in your healthcare provider.