The Electronically Empowered Patient

Do your patients search for healthcare information online before consulting you? Go ahead, ask them -- the answer may surprise you.

It used to be that patients needed to make an appointment with their doctor if they had questions about their health, said Daniel Z. Sands, MD, MPH, the Director of Clinical Informatics at Cisco Internet Business Solutions Group of San Jose, Calif. Physicians weren’t just comfortable with that arrangement, he says, they were empowered by it.

“Doctors historically have had all of the information and knowledge, and we hoarded it,” Sands said during his presentation “Information in the Age of ‘e’: How Participatory Medicine Improves Health Care for Both Patients and Physicians” at the 2010 AAFP Scientific Assembly in Denver. “We don’t want patients to have it because it makes us powerful.”

But increased access to the Internet and the profusion of quality healthcare information online are forcing physicians to relinquish some of that power -- and that’s a good thing, for patients and their doctors, Sands says.

Embracing the ‘e’ Patient

Today’s patients are using the Internet to become more educated and empowered about their health, according to a recent study by PewInternet.org, a project of the nonpartisan Pew Research Center in Washington, D.C. Its latest survey found that about two-thirds — or eight out of 10 U.S. adults – have gone online to search for health information. Even more telling: More than half of people who go online to find this information act on it.

“Contrast that to studies that show people listen to us less than half of the time,” Sands says.

Instead of ignoring the trend, he counsels physicians to embrace the “e” patient by talking to them about their Internet use. “Talking about searching for information online gives patients your tacit approval and builds a more trusting relationship,” Sands says.

Indeed, Sands encourages doctors to practice “participatory medicine,” where patients are urged to become a partner in their own healthcare, physicians can improve patient outcomes and, in the process, increase their job satisfaction, he says. Sands is one of the founders of the Society for Participatory Medicine, which aims to make healthcare providers more aware of the importance of educated and engaged patients making informed decisions about their care and treatment.

Ways to engage patients in their own care electronically include sharing and exchanging information, such as access to medical records, communicating with them via the Internet, and discussing and encouraging their own use of the Internet to improve their health, Sands says.

The Power of “I Don’t Know”

By not allowing your patients to become better informed and more engaged in their own healthcare, you risk more than your patients’ trust, Sands says. Physicians traditionally balk at being truthful with patients when they don’t have all the answers to their questions, which can add to their work stress, Sands says.

“Information can be a burden, we can’t know everything and the information changes all the time,” he says. “As physicians, we’re taught to never say, ‘I don’t know.’ It’s seen as a sign of weakness.”

When faced with a scenario where you don’t have all the answers, just say, “I don’t know,” Sands says, adding that most patients will think you’re honest. Instead of struggling for an adequate answer, he says, “Say ‘I don’t know, let’s look it up together.’ Be a partner with your patients.”Too at Ease With ‘e’?

While Sands says it’s a good idea for physicians to use the Internet to promote their patients’ health and participation in their own care, it’s important to be careful about the type of social networking they use.

“Web pages are important to get information to your patients,” he says, adding that websites such as Twitter can be an excellent tool for coaching and managing your practice. For example, he says, “Have people on a weight loss program post their weights, or post how long the wait is for walk-ins.” What you don’t want to do is get into a situation where you have the potential to breach your patients’ privacy, Sands says. (He acknowledged that he doesn’t use Twitter in his own practice.)

Sands recommends that physicians who want to incorporate social-networking into their business model read “140 Health Care Uses for Twitter.” A wealth of information and resources about the healthcare uses for Twitter is also available here.