The March 4 issue of the New England Journal of Medicine included the results of a revealing survey
of nearly 16,000 people over a seven-year period. The survey found that people’s trust in physicians has increased while their faith in information found on the Internet has subsequently decreased.
Perhaps more importantly, while consumers are scouring the Internet for answers to health-related questions, they then take the newly acquired information to their physicians for confirmation.
Sharon Horesh Bergquist, MD, the Emory Clinic Decatur
, and assistant professor of medicine at the Emory School of Medicine, is not surprised by the survey’s results.
Says Bergquist, “If a person has a symptom, and they’re trying to diagnose themselves based on the symptom, what pops up on the Internet will often cause the person more anxiety than help them. It increases trust when you can go to [a physician] and they say you don’t need to worry.”
That presents opportunities for physicians.
The collaborative approach
Bergquist says that the best approach to healthcare is a collaborative approach; a two-way street. It’s important for patients to feel they can share information with their physician, but it’s equally essential that physicians earn their patients’ trust so that the latter are willing to share that information.
Can't we all just get along?
With that approach, she says, physicians can then individualize a treatment plan for a patient. In contrast, the information obtained on the Internet, while sometimes valuable, is more generalized and may or may not be appropriate to each individual.
How can physicians begin to build this trust?
“I think it’s very important [for physicians] to listen,” Bergquist says. “Genuinely listen to a person both in terms of their social situations as well as medical problems. And work with them; make recommendations that are practical, not just textbook that may not be practical for a patient to implement.”
That’s a process that takes time. It’s also challenging, given the volume of available health-related information and the speed with which information changes.
“There’s so much going on in every aspect of healthcare,” says Douglas Elwood, MD, MBA, vice president and medical advisor, Health and Wellness, for New York City-based Widmeyer Communications
. “Keeping up [with the information] while still maintaining your daily practice is not an easy thing to do.”
But, he adds, “You don’t want a patient coming into your office and asking you a question about something new and not having an answer for them.”
Technology lends a hand
Elwood says that technology is helping physicians stay in touch, and points to smart phones, in particular, as enabling physicians to have unprecedented access to information. He explains that existing applications are already linking physicians more on a real-time basis to breaking news about drug recalls and other topics directly relevant to patients.
“Over 80 percent of physicians are projected to be using these phones by 2013, and a number of medical schools are already requiring their use,” Elwood says. “They’re the next generation of PDAs. There are applications like ePocrates that sound out rapid, real-time alerts when a medical is recalled. Just having that information on a real-time basis can affect patient care.”
This picture is an oversimplification designed to reinforce the statistic in the last paragraph.
It can also enhance trust, and help pave that two-way road. When patients ask questions during an office visit, physicians can take out their smart phone and say, “Mrs. Jones, let’s check that out together.”
Bergquist says she does that all the time, particularly where medications are concerned. “I pull up the database (accessed through Emory’s electronic medical records system) and I share the information with them. Looking something up in front of the patient buys trust, because it takes that bit of humility to say ‘I don’t know everything, but I know where to look it up, and where to guide you.’”
Elwood believes it’s possible to design outcome studies that can correlate patient empowerment and patient knowledge to outcomes, and says it’s already being done with some forms of technology such as at-home devices that monitor blood pressure and blood glucose levels, then feed that information to the patient’s physician.
“This is a real chance for physicians to get their patients even more dedicated to their own health,” says Elwood, adding that the overall fostering of trust between patients and physicians will “unquestionably” improve a physician’s bottom line. “As with any form of technology, there’s a learning curve that we’ll have to go through to get to that point that will augment the bottom line. But I think there’s no question that [physician’s using tools like smart phones] can do so.”