Putting the patient in the driver’s seat: How ever greater access to information can impact the dynamic of the doctor-patient relationship

Written by Emma Owen

Young Man Holding his Smartphone while Lying in a Hospital Bed

I’ve lost count of the number of times as a researcher I’ve seen a doctor roll their eyes and complain about patients consulting ‘Dr. Google’ before coming to see them.

It’s easy to understand their frustrations, particularly if on a regular basis they’re dealing with patients who have misdiagnosed themselves by looking up their symptoms online. If a patient is looking for information on their condition, you can safely bet that there will be multiple websites they can go to, ranging from Wikipedia to those set up by patient support groups, to the websites of treatment manufacturers.

And it doesn’t just stop at search engines. We are exposed every day to a huge amount of digital ‘noise’ around our health. People are increasingly tracking their lifestyle choices, symptoms, and treatment use via apps. Health blogs online proliferate. This is all before we factor in ‘word of mouth’ sharing of advice, which perhaps we should now more aptly name ‘word of keyboard’ via online forums.

Health is increasingly a part of our social consciousness through having all this information available at our fingertips. And this is having a noticeable effect on the way we speak to our doctors.

Traditionally the doctor’s role can almost be described as that of a parental figure – the expert who is in charge and who is the (selective) information provider, setting the expectation that the patient will be respectful and obedient to the ‘doctor’s orders’ because, of course, the doctor knows best.

But depending on where you are researching, you’ll find patients at varying levels of acceptance of this ‘parental’ persona. There is a cultural shift happening (to a greater or lesser extent in different places) towards it being not only acceptable for the patient to ask more questions, but also welcomed by doctors that their consultations will be a dialogue. Indeed, we have heard in the past from doctors that easily accessible information gives patients more control of their health, enabling them to take greater responsibility for their own outcomes – something physicians often welcome.

This shift in the relationship that patients have with their doctors can have a profound impact on their care. A patient who is comfortable with their doctor may open up more about the way their condition or the side-effects are troubling them, or may volunteer pertinent information that the doctor did not think to ask.

In rare diseases we’ve seen patients / families becoming increasingly more engaged and ‘expert’ in their condition, with greater than ever connectivity to others in a similar situation who can offer advice and support. In extreme cases, this can actually result in outright conflict with doctors, as patients are more prepared to ‘fight their corner’ based on their own knowledge.

But there can be drawbacks for patients too. We often hear from patients that the wealth of information available to them can be overwhelming, and put them under greater pressure to know what the ‘right choice’ is. Whilst some patients actively engage with the information available, others deliberately close themselves off from information about their condition, afraid of seeing ‘horror stories’ from others. We are seeing a reactionary swing from these patients, back towards the traditional role of physicians.

As this diversity in patient attitudes, knowledge and self-efficacy increases, doctors have to be ever more flexible in their approach to consultations and adapt their conversational manner to the patient sat in front of them. It’s not too surprising then that, as researchers, this dynamic between doctors and patients is increasingly something we are asked to explore by our clients.

As a result, we see many efforts from pharma are now targeted at patients (e.g. patient support programmes). But in this new era of patient centricity, perhaps the doctor’s needs are at risk of being overlooked. There are two sides to every conversation, and we need to also ask ourselves how pharma can help doctors adapt to this new norm to provide the best possible outcomes depending on each individual’s needs.

This article was written by Emma Owen who sits on The Patient Centre team at Cello Health Insight.

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