Recently controversy has swirled around a website, QuantiaMD, which provides a physician-to-physician educational presentation entitled, “Managing the Difficult Patient.” This controversy has raised questions about how patients can make the most constructive and helpful use of the vast quantity of medical information now available on the internet, and how doctors should react.
The QuantiaMD site, which requires free registration to access its content, includes segments for physician discussion and education, including ones called: “The Angry Patient” and “The Patient Who Knows Too Much.”
The Controversy
As reported by CNN, several patient advocates have now been tweeting, blogging and commenting, expressing outrage at some of the comments about patients posted by the doctors on QuantiaMD. The doctors’ comments and discussion do not name specific patients or reveal confidential information, but the tweeting and blogging patient advocates find them “upsetting,” “defensive,” or “condescending.”
In particular, the doctors’ comments in the segment called “The Patient Who Knows Too Much,” angered some patient advocates. This segment focuses on helping doctors know how to handle patients who increasing search the internet for information on their health conditions, and may border on the hypochondriacal, deluging the doctor with reams of mostly irrelevant information they have found that has made them fear they have all sorts of ailments they do not have.
“If you look at their videos, they seem to want to get rid of these patients,” says Sherry Reynolds, who tweeted about the “startling views” expressed by doctors in the videos.
Some of the doctors’ comments in this segment seemed condescending or overly defensive to patient advocates. For example, one doctor reportedly said: “Patients who present their expertise as telling you how to practice medicine are implicitly discounting your expertise.” Another described these patients as “indiscriminate” about the material they read online.
Patient advocates told CNN that “while doctors may find so-called ‘Internet patients’ annoying, online information has saved many.”
“If my mother hadn’t been a ‘difficult patient,’ she’d be dead right now,” said Sherry Reynolds. She explained to CNN that her mother’s breast cancer doctor didn’t sufficiently check her lymph nodes after performing a lumpectomy. Only through online research did Ms. Reynolds determine to take her mother to another physician, who found cancer remaining in some of the lymph nodes. After further surgery, her mother survived, and she is still alive now twelve years later.
Mary Modahl, chief communications officer with QuantiaMD, told CNN that her company now realizes “The Patient Who Knows Too Much” is “a very poor title.”
Ms. Modahl explained that the segment was not meant to discourage patients from using the internet wisely to educate themselves. “Certainly a patient can never know too much,” she said. “In every way we’re supportive of doctors meeting their patients’ need for care.”
She explained that the segment was actually trying to teach doctors how to deal with patients with psychiatric disorders, such as panic disorder or hypochondria, that may cause them to misunderstand or draw mistaken conclusions and fears from information they gather and then behave in irrational or unreasonable ways, as illustrated by the hypothetical case posed on QuantiaMD for instructional purposes.
The teaching module suggests that doctors handle such patients by listening to them, and then giving them reading assignments from credible sources and encouraging them to adopt a healthy lifestyle.
Tips for Patients and Caregivers: How Can You Constructively Use Internet Research?
Both doctors and patient advocates agree there are productive ways and bad ways to share online information with your doctor. The doctors and advocates suggested the following tips to CNN, for presenting the information effectively:
- “Don’t be afraid to be a “bad” patient. Patients who press their doctors sometimes get the best results.
- Share Internet information with your doctor wisely. Don’t walk in with a stack of printouts that your doctor won’t have time to read during the appointment. Instead, e-mail the information to your doctor before the appointment or boil the information down to a few points.
- Don’t be a cyberchondriac. Every headache isn’t a brain tumor.”
More Information
See more by CNN on Are you a ‘cyberchondriac’?
See also, Tips for savvy medical Web surfing, by CNN.
And see, Sharing Internet Health Information With Your Doctor, by Trisha Torrey, on About.com.
For a list of trusted reputable medical resources online, see HelpingYouCare™’s resource pages on:
Links to Other Medical Resources; and
CAPHIS | Top 100 Health Websites You Can Trust.
And see our resource pages on 14 Medical Conditions Commonly Faced by Seniors, in which we present information based on and linking to credible and reputable clinical and governmental websites. For each medical condition, we separate the information presented on each sub-page into that derived from “Classic Sources” and “More Sources (Constantly Updated).”
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