“We live in a time when we have to spend a lot of our time undoing misinformation”

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“What Used to Be Fraud Is Now Alternative Medicine…    …Sometimes a very, very common story that I hear is, “Yeah, I saw two or three physicians. I think I have Lyme disease, and my physicians say I don’t have Lyme disease because my tests are negative and I don’t meet the criteria,” whatever. “But I looked up the symptoms on Google and I have all the symptoms. So then I went to a naturopath and he did a lot of tests on me, and he says I do have Lyme disease, and he gave me this homeopathic remedy for it. This is unfortunately a common occurrence. Obviously, we have to form a therapeutic relationship with our patients and you can’t be judgmental towards them, so it’s a very challenging framework in which to confront these issues. But I think a few things. One, if a patient is in my office, they’re there to get my professional advice and they are already acknowledging by their very presence that they have some respect for science-based medicine, for evidence-based medicine. I do think that they expect that I’m going to give them my honest opinion, and so I give it. I say, “Listen, I looked at the research on this, and in fact, I do not think that this is a valid treatment. I don’t think that this is going to be effective,” or “I don’t think that you have Lyme disease for these reasons.” They generally appreciate the fact that I took the time to actually look at the literature even though it may be more of a fringe treatment and not something that physicians are giving, and they appreciate that I take the time to explain to them why I feel the way that I do. I don’t pull my punches, but I say just very non-judgmentally, “These are the facts. This is my interpretation of the evidence,” or “Here’s the standard recommendation of the relevant professional society. This is why we think…” You also have to gauge what’s the patient really thinking? You can’t just lecture them. You have to sort of interact with them. Sometimes they have misconceptions that are pretty easy to fix. So, it takes … you have to invest the time to understand the narrative, understand what the patient is thinking, understand what they want, address the information that they’re being given. So, yeah, we live in a time where we have to spend a lot of our time, I think, undoing a lot of misinformation that’s being fed to our patients, but it’s absolutely worth it and the effect could be definitely worth the time that you’re investing. Because if you think about it, you could have the best plan for your patient that’s all science-based and has class I, double-blind, placebo-controlled clinical trials, but if they don’t believe it because they were told something else by their naturopath or whatever, it doesn’t matter. You have to get them to buy into how to approach the therapeutic strategy that you’re going to be taking. Patients do share with us. We all want to use what works, right? We want to know what works and what is safe. We all have that same goal and you should have a pretty sophisticated understanding, I think, as a practitioner of how we know what works and how we decide what is above the waterline in terms of using it. You should get the patient to understand that at least … they’re going to buy into your treatment recommendations…”

Some invaluable points made in this interview with Steven Novella MD, Neurologist and host of the “The Skeptics’ Guide to the Universe podcast.

While it’s very disappointing that in the USA the healthcare system is so broken that the only viable corporation providing a direct Doctor video consult service is just filling prescriptions for cannabis I think this interview with Dr Novella brilliantly explains why we need to move beyond offering the “visit a stranger in their office” model of care and urgent need to train medics to use the internet with their Patients because in 2017 while every Patient/Carer is Googling their symptoms/diagnosis we still have young Doctors coming out of some of the best UK medical schools not realising that Patients judge them by how they use the tools of our time and 50% of US Medical Students believe that using a mobile in front of colleagues/patients would make them appear less competent.

Related post: Malcolm Gladwell: In the cause of efficiency we’ve disrupted the very thing the Patient really wants

About David Doherty

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