Be informed -

your research, your way

Dear Doctor

To google or not

 

We have a conflict going on – a conflict of approaches, a conflict between an outdated paradigm and a paradigm emerging.

  1. Patients, trying to inform themselves, are increasingly doing on-line researches to find out as much as they can about their possible condition. Patients re becoming more informed.

  2. Doctors don’t like patients doing this and make sarcastic comments or threaten to cancel the patient from their list.

 

In fact, I read in today’s Independent (14th October 2017) that GPs are threatening to remove patients from their practice lists if they have relied on “Dr Google” to find out what is wrong with them, and be better informed, before their appointment. 

 

What utter nonsense. How petty.

 

I have met one too many GP or nurse who has been totally ill informed on nutrition, diabetes, certain drugs etc and if I mentioned that I have done my research they go ballistic. WHY? 

 

Do they feel so threatened and disempowered that they do not like an informed patient?

 

Their defence that the internet is not to be trusted shows just how little they know. The Internet has many professional health bodies with websites – the NHS for starters! Why should a patient not consult the NHS website and inform themselves? Especially given GPs do not have the time or simply do not bother to explain things to the patient.

 

Why should a patient not find the many reports, research papers, the websites of so many robust medical bodies – The Lancet, The BMI – and use them to inform themselves?

 

Where did GPs get this idea the website is not to be trusted? Why do they automatically assume a patient is self-informed through the internet alone. I have completed many medical courses. Where did they get the idea that patients are not to be trusted to use their own intelligence to do the research and reach their own conclusions.

Where did they get the notion that they are the harbingers of all knowledge?

 

It simply shows how inefficient, ineffective, and incompetent our GP system has become, They are generalists after all.Patients are dealing with the specifics of what is going on for them.

 

 

I have heard from patients who have been mocked, shouted at and left feeling intimidated for carrying out their own internet research by doctors who fear “a loss of power”. And yet, the NHS proclaims it is to be patient centred, empower patient – it certainly does not practice so.

 

 

Many patients I know dread appointments for fear of their doctor’s reaction. Even getting an appointment is now a battle, such are the pathetic excuses for systems in GP clinics.

 

How sad it is that clinical leaders are having to educate GPs on how to not dismiss patients’ research so readily.

 

According to today’s Independent article, “Alison Richards, from the Royal College of GPs’ Patient and Carers Partnership Group, said there has been a rise in the number of “cyberchondriacs” in the UK. Ms Richards said the idea for a session she hosted at the RCGP annual conference in Liverpool, called “Patient information: what rubbish are you reading now?”, came from an increasing number of patients sharing negative experiences online. A lot of people were posting things [on forums] indicating they have had really bad experiences with their GPs if they mentioned anything to do with reading something on the internet,” she said. “They were laughed at, they had eye-rolling, [doctors saying] ‘oh, you’ve been Googling again?’ Some of them have been shouted at. Some of them, if they raised something that doesn’t chime with what the GP thinks, have been threatened with being removed from the GP’s list.” Although practices have the right to ask for a patient to be removed from their practice list, the situation should be “an exceptional and rare event, and a last resort in an impaired patient-practice relationship”, according to the British Medical Association.

 

Ms Richards said: “People have been dreading appointments, psyching themselves up to go and talk to a GP. Now I’m sure none of you here would have done that, but it is an issue and we thought it was useful to have a discussion about how you manage patients’ knowledge, going onto the internet in a way that could benefit both patient and clinician.”

 

But how can we have any trust in Richards when she kicks off calling patients, “cyberchondriacs.!” It’s as if she is laughing at the patient, dismissing the patient, treating them as unimportant. Hands up, I wasn’t present.

 

The current reality is when I go to my GP, we have ten minutes for the consultation. That’s all , he probably will quickly prescribe a drug which is useless, known to be useless, and has numerous powerful negative side effects.

 

So it stands to reason I am going to go researching. So would you if took responsibility for your health.

 

GPs need to get used to the fact that they are not the founts of all knowledge – why should we have an archaic system whereby we always have to have the GP as gatekeeper?

 

Patients know that GPs aren’t expected to know everything but doctors seem incapable of owning that fact yet they can’t admit to not knowing something. For me, I have read books, attended courses, both online and in person, most run by medical people. The sad fact is the GP wants it all ways. And they cannot have that in a a partnership.

 

I have countless occasions when I have done my research, gone to a GP with a few questions, only to have them dismissed. I’ve even written, at a time I was desperate, to a GP – and he never once offered to discuss my concerns. All totally ignored. From comments from other patients, this is the norm in the NHS. There are a few exceptions.

 

Patients have every right to inform themselves – and it is not just through Dr Internet. For me, I have read learned books, joined website forums (where you can get loads of signposts for information to research from others going through the system and processes) at my own expense signed up for courses run by medical people – both in person and on-line. So doctors, get used to the fact that patients are informed and probably far more up to date  than you are.

 

You are generalists, dealing with a whole range of issues in a day, but we, the patient, really only have ourselves to worry about and so we have much more time and inclination to be focussed, to go looking on the internet, read books, attend courses, to find out about our condition. It is called self-responsibility, informing ourselves, and it is our right to do so.

 

As patients, we can understand your legitimate fears about self-diagnosis, we get it. But this is here to stay. You are not the only people who have knowledge -most of it outdated.

 

And it is NOT appropriate to put a note on my records, for all to see, “Beware Dr Google.” This is akin to the bad old days when doctors had a code on a patient's records to indicate they were gay and / or  had HIV.

 

Informed patients are not going to go away and you need to work out ways of working with them in a mature way, treating patients respectfully as informed partners in their health care. Oh I know the NHS will say that is what we do -  it is not happening in practice….except for the few.

 

I often use  NHS sites – not always the easiest to navigate – try entering a search under  “your condition + NHS!” - they provide excellent, clear information about the physical causes of conditions and what treatments may be possible. 

Another reliable site is www.patient.co.uk

 

Remember, however, that these sites focus primarily on the body on physical symptoms, and work to the bio-medical model in the NHS. They do not cover modern functional, integrative, nutritional, complementary approaches to health. Neither do they focus on creating health but on dealing with symptoms, not their causes.

 

By all means consult thee conventional sites BUT also do your own research on a much wider, deeper, holistic basis.

© 2017,2018,2019  by Andrew Hunter

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