Letters to the Editor
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Good News from the Front
The author is quite right in his call for the medical community to embrace the internet. As a current medical student I can spread good news; medical education is being tailored to fit better with the educated patient. Today's patient should use every advantage of the internet to better understand his or her condition, not only because medicine is a somewhat subjective field, but because taking an interest in one's health is prophylaxis for future illness. For instance, research studies (think cohort study, Framingham) can't be evaluated without taking into account the simple fact that participants were thinking about their health. People who enroll in studies are healthier and so, clinical research may inherently underestimate risk. When applied to the internet, one can expect that more educated patients will tend to be healthier patients, the goal both parties are striving to attain. On the other side of this argument is the manner of presentation. It seems to me that often patients don't want to be dismissed as incapable of understanding and in response can become almost aggressive. Doctors under go a great deal of training in developing the "patient-doctor" relationship, a subject in which the patient receives no training. While we work on adapting to the educated patient, I would suggests the patients work towards this goal as well. To that end I recommend a great book, "YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment". Together, both doctor and patient can elevate the level of care and still maintain a strong relationship.
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A Dr. harmed me, never trust again
Thank you for your article Dr. Parikh. The only thing not mentioned is that there are doctors that are not wonderful. Most are, I'm glad to say.
In 1989 I had an accident and the doctor I was referred to gave me medication that destroyed my stomach. When that doctor told me I should have spinal surgery I went outside my insurance network to someone recommended to me. I finally got good treatment. But too late for my stomach. Now I go into old age unable to take ANY NSAID or drug that is harsh on the stomach. I am in pain daily due to the limitations on what I can take or even eat.
I relate this experience to illustrate how an educated patient can help in their treatment. There was no where to go to get information when that happened to me. Now I always research any treatment or drug before agreeing to do it. Due to a rare blood disease this has been a really good thing.
I do not go to any doctor that doesn't engage me in my treatment. In fact I almost always go to doctors that are not in any HMO network because over time I found they are not as rushed and they are usually much more interested in my treatment.
I had a knee injury a few years ago, and when looking for a second opinion I researched the doctors in the field. That led me to an innovative doctor who was able to repair my ACL without using a cadaver replacement. Due to my inability to deal with drugs this meant the surgery was less invasive and that was a big deal for me. The doctor was not taken aback when I told him that I chose him due to his steller record and the papers I read by him. He laughed and said he hoped he could live up to my expectations. He most certainly did.
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"Anonymous" wrote this immediately below...
"Now I go into old age unable to take ANY NSAID or drug that is harsh on the stomach. I am in pain daily due to the limitations on what I can take or even eat."
That's a shame that you find yourself in that position. Even more so, because there is, or was, a whole class of really innovative medications called Cox-2 Inhibitors, that were designed for people like you. Vioxx was one of the Cox-2 Inhibitors.
Sadly, the trial lawyers (see, e.g. "John Edwards, et al") have succeeded in stmpeding a credulous popular press and frightened Merck executives into pulling it from the marketplace. All due to litigation costs.
Score it trial lawyers 1, patients 0.
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rat poison?
Dear Chikalada,
How exactly did you feel when you felt as though you'd taken "rat poison?"
Use hyperbole much?
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Bitter Pill
Haha, I do, actually!
But . . . don't you remember in the seventies, when everyone was smoking rat poison to get high? No? Before your time? Oh well. You didn't miss anything, believe me.
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time to move on
'Susan's' need for help far exceeds what the internet can offer. Does anyone disagree? Narcissistic, stalking behavior is nothing a physician should be compelled to work with in a consumer. There are, perhaps, other physicians willing to pander to treat someone who obviously needs far more than diagnosis and treatment.
I've never come across a physician who felt that arriving in their office with information was threatening. I believe that Dr. Haig acted both ethically and safely - for himself and his family - when he sent the very rude and personality-disordered Susan elsewhere.
Are we oversensitive to the perceptions of physicians? Probably. But why? Didn't we do this ourselves? And aren't we still doing it by giving this much time and energy to a single case that shouldn't be misinterpreted because Dr. Haig protected himself?
-not a doctor