Wednesday, August 06, 2008

The problem with doctor/patient relations in the internet age

Doctors tend to be suspicious of patients who learn things on the internet. I guess they do get people who see some drug ad on TV or blindly trust the first google result to diagnose them even though it's from Ask Yahoo. The problem is I do know how to use the internet judiciously for medical research. I can evaluate the reliability of sources, I can google up independent confirmation, I can double check whether I'm getting confirmation bias, it's essentially my job. I wouldn't have made it past my first practicum if I had poor google judgement. So if I walk into a doctor's office with information I've found on the internet, at the minimum I've done the first level of troubleshooting myself (like when you try to reboot and system restore before calling tech support), and it's quite possible that I've gotten as far as a proper diagnosis and all I need is treatment. But I don't dare say the I-word to the doctor, because their shields immediately go up and they get suspsicious about everything I might say.

Actually, the same thing happens when I get strep throat. I get strep throat almost every year, I know what it feels like, I know I need antibiotics. But if you go into a doctor's office and say "I know what the problem is, I get this all the time, just give me the drugs" they are (understandably) suspicious.

The problem with all this is I feel like I have to play dumb every time I go into the doctor's office. I feel like I have to put on the big green eyes and little girl voice (which I'm really getting too old for and should break the habit of, but it still works more reliably with unknown interlocutors than the assertive grownup act) and describe my symptoms like all gosh golly I'm just the patient you're the big smart doctor, manipulating them into arriving at the diagnosis I've already arrived at. I hate that. It makes me feel like some one-off Sweet Valley High character trying to land a football player and being advised on flirting techniques by Jessica Wakefield. If I wanted to play dumb to convince other people they're oh so smart so they'll do what I want them to, I'd go be a trophy wife!

At this point people always tell me that I have to be assertive, but when I'm assertive that seems to get me subconsciously labelled as a difficult patient and the doctor pushes back like they're actively trying to prove me wrong. The only thing that seems to work is ditzing, and that is very hard work. I wish I could just go in as myself, a competent adult who is capable of reading and thinking and the occasional medical translation.

3 comments:

laura k said...

Hmm. My experience with doctors has been different.

I wish I could just go in as myself, a competent adult who is capable of reading and thinking and the occasional medical translation.

I pretty much do this - substitute my own research for the medical translation part - and it works. The doctor accepts that I've learned something, either confirms it, adds to it, or re-calibrates it to fit the current Health Canada protocol, and that's that.

If she disagrees with my self-diagnosis, she'll tell me why, and if it makes sense (which it usually does), I'll defer to her.

Do you like your doctor in general? Maybe it's doctor-specific.

impudent strumpet said...

It isn't doctor-specific, I've had it with a number of doctors. People have since suggested that it might be an age thing, because it tends to happen with with doctors who are old enough to be my parents but I haven't had it with younger doctors. But the younger doctors were at the clinic I went to in uni, so it's possible that I was more deferential then because I wasn't really used to managing my own health care.

laura k said...

Yeah, I realized it couldn't be doctor specific.

I've had bad and good doctors, but I haven't had a bad doctor since the advent of the internet, or since it started to be widely used for medical/health research.

If I saw one of those bad doctors now, I'd probably have the same experience you're describing here. I think the only reason I haven't encountered it is because I've had good doctors, who listen and respect their patients' intelligence and knowledge.