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    Are educated patients good for medicine?

    Rich Horecka, MD, still knows what it’s like to be the “voice of God” for his patients.

    The family doctor in rural Benson, Minnesota, cares for many elderly patients, including a handful over the age of 100. He has treated some for decades and the older they are, the more they accept his recommendations without question.

    “Whatever I tell them is gospel,” he says.

    Their children and grandchildren? Not so much. When his elderly patients are accompanied to appointments by younger relatives, Horecka is more likely to face questions about treatment plans, diagnoses, options and the latest research. His word is no longer gospel.

    In the 34 years he’s been in practice, he has seen the doctor-patient relationship evolve from one in which physicians did all the talking while patients listened to one in which it’s not uncommon for patients to produce a stack of internet printouts and announce they’ve diagnosed themselves.

    Horecka, who is part of a large multi-specialty practice, welcomes the change: “I tell my patients, ‘This isn’t my disease; it’s yours. I want you involved.’”

    Paging Dr. Google

    Virtually every primary care physician deals with self-educated patients, people who consult a variety of sources for information about their conditions and treatments and who sometimes regard the advice of their doctor as just another opinion to be taken under consideration.

    There are several reasons why patients have become more proactive and less deferential to physicians, including a decline in the prestige of doctors brought on by news of medical errors and misconduct, direct-to-consumer advertising by pharmaceutical companies, misleading media coverage of medical research, the rise of alternative medicine and patients’ growing share of healthcare costs. But the primary reason patients are doing their own research is because they can.

    The internet makes it easy by putting an overwhelming amount of healthcare information—phony and legitimate, sponsored and independent, clinical and anecdotal—designed to educate and designed to sell—at the fingertips of patients. More than a third of U.S. adults have gone online to diagnose a medical condition that they or someone they knew had, according to a 2013 study from the Pew Research Center’s Internet & American Life Project.

    The survey found that 59% of adults looked up health information online, with search engines like Google and Yahoo as the most popular starting points. Non-clinical health websites like WebMD were the next-most popular places to search, followed by Wikipedia, Facebook and other social media sites.

    Of those who went online to research a condition, 46% said their findings led them to believe they needed help from a medical professional. Another 38% said they thought they could treat it themselves.

    However, only 41% said that a doctor confirmed their self-diagnosis; 35% said they did not seek a professional opinion; and 18% said the professional did not agree with their conclusion.

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    • Anonymous
      "Patient self-education usually is beneficial," according to an article written by James F. Sweeney and published in the July 10, 2016, edition of Medical Economics. "It's widely accepted that engaged patients tend to see better outcomes and are more likely to adhere to treatment plans." In fact, according to a 2013 study from the Pew Research Center, more than a third of U.S. adults have gone online to diagnose a medical condition that they or someone they knew had. And of those who researched a condition online, 46% said their findings led them to believe they needed help from a medical professional. We've seen this very phenomenon in our own practice, again and again, and it's why we created CardioVisual. Patients who come into the office armed with information from Dr. Google may indeed have the wrong information, but at least they are actively participating in their care, and that's absolutely a step in the right direction. Apps such as CardioVisual allow us to make sure patients have access to correct information, and they allow patients to study and learn at their own pace. The Medical Economics article, titled "Are educated patients good for medicine?" also asserts: "The internet makes it easy by putting an overwhelming amount of healthcare information — phony and legitimate, sponsored and independent, clinical and anecdotal — designed to educate and designed to sell —at the fingertips of patients." That's why it important to point patients to authoritative sources, rather than letting them flounder about on the internet, reading who-knows-what gibberish. CardioVisual is a multimedia platform that allows healthcare providers to explain, discuss and demonstrate conditions, procedures and devices with patients and colleagues using a vast library of short animation videos and illustrations of most cardiovascular areas. This tool aims to enhance provider-patient interaction, to improve patient understanding of complex cardiovascular issues.

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