I've noticed that knowing things your doctor doesn't know can be a liability for you.
Why? They can think that you're crazy.
Here's how it goes: Patient: (explains symptoms) Doctor: I think that's nothing/I think it's just the usual.
Patient: But (information they know from researching their health issue).
Doctor: (trying to save face:) I've never heard of that (implying the patient is crazy or misinformed from what they read on the internet: "you know, you can read anything on the internet...
").
What's a patient to do? How can you be an educated patient and still get along with your doctor? 1) Provide evidence from authorities that the doctor respects.
If there are any major, AMA-respected organizations that agree with your point of view, memorize or bring the evidence! It will go a lot further with your doctor than, "I read it on a forum.
" For example, the American Association of Clinical Endocrinologists (AACE) revised the TSH guidelines to "consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.
3 to 3.
0.
AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now.
" However, many labs still see a TSH up to 5 as normal.
If your doctor thinks this, bring the info from the AACE.
2) Give up on trying to educate or convince your doctor.
They've been through a hellish education and probably have years of clinical experience, so they do know a lot.
In most cases, they're not about to learn something from you.
Instead, appeal to the lack of harm posed by the test or treatment that you want.
For example, say, "It couldn't hurt to test my free T4, could it?" I've found that my nurse practitioner is usually willing to try tests, referrals, or low-risk treatments, even though I have yet to convince her of anything I know from my own research.
3) Ideally, you'll go to a doctor who knows more than you about your condition.
Even in this case, it's good to do your research, so that you can speak your doctor's language and alert them to things they might not have considered.
It pays to learn about your condition yourself! As a doctor said to my friend, with so much medical information available on the internet, patients often have access to almost as much information as doctors.
I think doctors might be taking a while to adjust to this, but in the end, I think it's better for all parties involved: 1) Educated patients are easier to talk to, since they have a basis for understanding what the doctor knows and wants to tell them.
2) Educated patients can aid in their own diagnosis.
Patients have access to vastly more information about their bodies than they can explain to the doctor in a brief appointment.
I hope doctors will come to be grateful when patients do a lot of the legwork of researching their symptoms and suggesting possible explanations.
The doctor still needs to think about what might be going on, but the patient's input can help them to think of things they might not have thought of otherwise.
3) Educated patients can catch things that might be bad for them, such as contra-indicated treatments, drug interactions, and tell-tale symptoms or side effects.
This provides another set of watchful eyes besides the doctor's, to help cut down on improper treatments or to respond quickly to negative reactions.
Jerome Groopman wrote in How Doctors Think about how doctors frequently miss things due to "diagnosis momentum" and the snap judgments required for high-throughput care.
He mentions on the last page that patients and their families and friends can help doctors to think about what they might be missing by asking, "What else could it be?" and watching our for errors.
I hope that doctors will come to welcome the greater patient education made possible through the internet.