There
was a time when the only access patients had to information regarding their
health care or other medical problems was through their physician. And physicians,
as the gatekeepers of this information, were viewed with a level of respect
because of this unique knowledge that they possessed. I was a child of the
1980s and had one such family physician who was lauded in the community where I
grew up. He was a good man, an intelligent one. I remember my mother bringing
me into his office one night after school. I was coming down with some common
school-age malady. As I was sitting in his waiting room near my mother’s side,
sniffling, sneezing and wincing at the pain in my throat with every swallow, I
looked around the room and watched as patients were called back, one by one,
for their examination. I watched as people trudged toward the nurse at the call
of their name, heavy with what seemed to be the weight of the world on their
shoulders. But after a time, the door to the exam room opened and they would
walk out, with more vigor and purpose, with a look of calm or even the hint of
a smile on their face. And I thought to myself, my God, what kind of man is
this? This doctor has the power to take a sick, unhappy, unhealthy patient--
and heal him – body and soul, restoring
him to his former self! I thought to myself, I would like to be like this man,
to heal people—and make them well again. He has the answer for every problem,
and patients seek him out, looking for the answers.
My
childhood was also unique in that it spanned the growth and movement of
computer technology into the private sector. I remember being taught in
elementary school how to write program lines in DOS. As I continued to move
through primary school, high school and
college, I watched as computers relied less and less on a user’s knowledge of programming
to perform tasks and instead provided user-friendly interfaces so that anyone,
even those without a technology background, could find them easy to use. Then came the late 90s and the advent of the
Internet which over the years grew and flourished to become a place where
people anywhere at anytime can find out information – readily available at the
tips of their fingers.
Some
of the information people choose to seek is information regarding their health
and medical problems.
Thus
sprang forth WebMD, MedlinePlus, MedicineNet and a slew of other sites. Now,
physicians are no longer the gatekeepers of medical information. Now, all a
person needs is access to an internet provider to diagnose himself. Now, a
person can forego years of medical education and sacrifice because he himself
can do a review of systems, generate a differential, consider the appropriate
studies, interpret the studies, diagnose and suggest treatment – because all of
that information is available to him at the touch of a button. Right? Well, not
exactly.
Some
of my colleagues over the years have viewed the ease of access to medical
information online in a negative light. They feel that there is a certain loss
of respect for doctors that has occurred because doctors are no longer the only
sources of medical information for their patients. As a doctor myself who examines
and treats many patients every day in the office, I do understand on a very
personal level why some physicians feel this way. I always have a few patients,
few as they may be, who come in with a pre-conceived diagnosis who are
unwilling to accept my explanation of their condition because they have read
(or interpreted) something ‘different‘ online. (see my previous blog entry “
A Stye Caused My Presbyopia” ).
In
the past, when I encountered these patients, I have to admit I would be
disappointed because I felt that I could not overcome the wall they set up in
order to educate them appropriately about their condition. However, I’m feeling
less and less of that frustration these days. At some point I decided to take
their faith in the Internet and make it work for me.
As
an ophthalmologist, I truly love the American Academy of Ophthalmology’s
website: www.geteyesmart.org which
also has an equivalent Spanish-language version: www.ojossanos.org . It is trusted and correct information
regarding eye disease and treatment, because it comes directly from the Academy
and is updated frequently to keep up with advances and changes in the field of
ophthalmology. It is written in plain language, so people without a medical
background can understand the topics with ease. Further, every eye disease is
broken down into its definition, symptoms to look for, studies, exam, diagnosis
and treatment. Patients can easily click on their topic of choice and share
that topic with their friends or family through Facebook, Twitter, Google+ or
any other number of social sites. Best of all, the articles instruct patients
to review the information presented them, formulate questions and review their
unanswered questions and concerns with their physician.
The
reality is that today, we physicians are still the gatekeepers. We may no
longer be the sole proprietors of the keys to medical information. But, we’ll always be the master interpreters
of this information. Data means nothing unless it can be analyzed and put to appropriate use.
“Quiero
repasar todo la información de su examen. Los nervios ópticos son sospechosos
para una condición se llama ‘glaucoma de
ángulo abierto’.”
“¿Qué
significa eso?”
“Glaucoma
es una enfermedad del nervio óptico que, poco a poco en tiempo, puede resultar
en daño del nervio, y el paciente pierde la visión periférica.”
“¿Podemos
curarlo?”
“No
hay cura, pero podemos pararlo con tratamiento en la forma de colirio.”
<el
médico le da al paciente un papel con escritura>
“Aquí
puede encontrar el enlace para un sitio en la red “ojossanos” donde hay más
información de esta enfermedad y tratamiento. Después de leerlo, si tenga
preguntas, por favor, llámeme.”
“Está
bien, gracias.”
 |
| Open Roads, Monument Valley, Utah |
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