More patients turning to the net
MORE people are going to their doctors armed with massive stacks of
paper.
They contain information the patient has printed from the Internet
on what he thinks he is suffering from.
So when the doctors tell them otherwise, the patients not only
refuse to believe them but also begin to argue with them.
Often, many of the patients are wrong.
Patients looking to the Internet for medical information is a
growing trend here, say 10 doctors who spoke to The New
Paper.
Dr M Wong, 41, a general practitioner, reckons that, based on
feedback from private and government doctors in the last three to
four years, there has been a 10-to-15 per cent increase in the
number of patients who have read up on the disease on the Net
before they see a doctor in a polyclinic. In private practice the
figure is even higher: 25 to 30 per cent.
This is inevitable, said Dr Tan Sze Wee, Singapore Medical
Association's spokesman and treasurer.
GOOD BUT RISKY
He said: 'This is part of self-empowerment and knowledge for the
patient, and it's a good way for him to know if the care-provider
is doing a good job.'
But it's risky, too.
He said this can be disruptive to doctors, especially when the
patients do not understand what they have read or have looked up
wrong information.
One way to prevent this is for doctors and patients to work closely
together.
Dr Tan added: 'Doctors should keep themselves updated, in the
mainstream, and know what it is that patients are interested in
nowadays.'
One example, he said, was weight loss. Patients would go on the Net
and look it up and Dr Tan said doctors should be familiar with the
information available.
When patients come up with their own wrong diagnosis, doctors
should tell them where to go on the Net to look for the right
information.
Dr Wong recalled: 'One patient even diagnosed himself from Net
information! And he was wrong.'
He added that websites such as Medscape or WebMD were very good and
the public should also note if such sites are funded by grants from
the medical industry as this is a good indication of their
reliability.
Some patients go to the Net after consulting their doctor, which
most doctors agreed is a good practice.
Dr Wendy Low, 40, a general practitioner, has had several patients
coming in armed with pages printed off the Net asking her to
explain the text.
She said: 'It's good for doctors if the patients need more
information and they go and check up specifically what they need to
know after consultation. During consultation, it's not possible for
the doctor to tell the patient everything in the limited
time.'
All the doctors agreed the old patient/doctor relationship where
the patient did everything the doctor asked is gone.
Today patients want to know about everything that has to do with
their condition.
Dr Wong said: 'You can help to educate the patient by showing him
what to read and where to find the relevant information. Along the
way you will get a much better informed patient.'
But there is another danger - waste of precious time.
Doctors are faced with having to sift through a morass of
information, much of which is wrong, outdated or unrelated to the
patient's condition, said emeritus consultant Professor Feng Pao
Hsii.
Prof Feng Pao Hsii
THE NEW PATIENT
That's why he wants to create the New Patient.
After over 40 years working as a rheumatologist, seeing patients
with fong sap or arthritis, the man who founded Singapore's first
and oldest rheumatology department at Tan Tock Seng Hospital has
found a new calling.
He wants to create a 'health-literate' patient who can take charge
of his own disease and be a partner to the doctor.
Patients, once grateful, are now more demanding, often
non-compliant and occasionally confrontational.
'Some don't listen to you and doctor-hop. They look up information
on the Net and challenge you. For this group of patients, the trust
between doctor and patient is gone, so it's very difficult to
manage,' he said.
When he first entered the profession, people looked up to doctors.
He said: 'People did what they were told even when they did not
know what they were taking.'
These days, however, medicine has become big business, with cost
considerations and customers bent on getting their dollar's
worth.
To help them, he has kicked off his New Patient project by holding
his first series of 10 three-hour public lectures at the NUS
Extension at Park Mall from January to June this year.
He wants to 'demystify medicine' and help patients ask the right
questions and gain the right medical knowledge.
His lectures also give pointers on where to go on the Net for
information.
'The Internet is like the wild, wild West. It is unregulated and
you can find all sorts of information there. And many of the sites
exist to push certain products. The trick is to know where to go to
find reliable information,' he said.
His next project is to start a website where anyone can access his
lectures. He is busy looking for a sponsor as he said it will cost
about $15,000 to start it.
Log on to www.patientempower.org.sg to read some of his
lectures.
Surfing the right channels
SHE used to type in a keyword on the search engine when she was
looking up information on her medical condition.
Then, said Ms Agatha Lau, she would laboriously surf as many
websites as she could, one by one.
But she never knew if what she was reading was correct.
Often the language was not easy to understand.
So she never challenged her doctor.
But she wanted to know more.
So she jumped at the chance to attend one of Prof Feng's
talks.
Ms Lau, 36, a customer services officer, said: 'I have kidney
problems so I chose the module on kidney disease.'
It was better than getting information from the Net, she
added.
For that particular module, Prof Feng spoke on functions of the
kidney, kidney stones, urinary tract infections and various types
of kidney diseases.
'Before, I had a very hazy idea about kidney diseases. Now I have a
detailed understanding. Prof Feng mentioned things like high blood
pressure affecting the kidneys. I didn't know before it could
affect the kidneys.
'The best part about attending the lecture was that I could relate
it to myself,' she said.
During the lecture, Prof Feng highlighted a few useful websites
such as Merck.com, WebMD.com and Medscape.com
Ms Lau said: 'It gives me a better compass to navigate the Net and
I can cut down on the time spent surfing. But when I have nothing
to do, I will still surf the Net. I know that ultimately, I still
need the doctor as what I read may not apply to me.'
SOurec: NP
