Saturday, May 15, 2010
Many of those who know me understand that I promote active participation of my patients in their own health care. Doctor as teacher is a huge concept in my current practice and I empower patients to learn about wellness and strategies that they can implement to support healthy lifestyles. However, I must identify something that has become quite prevalent in my own practice and (from what I hear from my colleagues) in the general medical community. Active participation does not mean patients become the experts in their own care by dictating what their diagnosis is, choosing medications and dosages, or even what laboratory and/or imaging tests are most appropriate for an initial diagnosis or continued monitoring of a condition. This is not to say that I would neglect to hear a patient's view or consider something that they have suggested that perhaps I had not previously considered or that I am all-knowing and never overlook something that is relevant in the patients case, OR that I am not open to new concepts and progressive treatment options. BUT there is a line to draw and that is being the expert opinion on how applicable an approach is to the unique and comprehensive medical picture of the patient that subscribes to your care.
The internet has become a useful and convenient tool for medical "research" and is like hiring consultants to gain insight on an otherwise unscientific view to make decisions in your own healthcare. This is a fairly incomplete and irresponsible approach. Regulations are in place to help keep communities safe and maintain order in complex medical and scientific processes that the people (for the most part) are intellectually unequipped to manage themselves. In the meantime, we all still maintain the right to accept or refuse treatment of any kind (maybe even based on the opinion of a consultant or an article that we read somewhere). Freedom (in part) to me is being free to live in a civilized environment with access to advanced medical, regulatory, and legal guidance that helps protect us and helps take most of the guesswork out of the health-related choices we make. Of course I agree that the systems fall short in many cases, but we also live in a free society that changes these systems to improve its utility in regard to our continued well-being.