Medical Googlers part II

Dr. Rahul K. Parikh has written a response in Salon.com to Dr. Scott Haig's Time article "When the Patient is a Googler." Dr. Parikh suggests that physicians should not disdain the
Internet, but embrace it. Having informed patients ultimately helps the doctor do a better job, as patients who understand their treatment are more likely to comply. And the doctor can be a source for pointing patients to reliable web sites so they can learn reliable, understandable information. You can see the article here: http://www.salon.com/mwt/feature/2008/01/10/web_doctor/index.html.

As I have said before, effective patient-physician communication is the responsibility of both patient and physicians. Physicians have a responsibility to effectively inform patients in a language the patient can understand so the patient can make a truly informed decision. Patients have a responsibility to be honest with their doctor and to take an active interest in their own health. The Internet can be an effective tool to keep both patients and physicians informed. But both have a responsibility to use and study such information to supplement the practice of medicine and the patient-physician relationship, not replace it.

Heart Health and Diet Coke

The National Institutes of Health's National Heart, Lung and Blood Institute is partnering with Coca Cola to bring awareness to women's heart health. Diet Coke is sponsoring NHLBI's Red Dress Fashion Show during Fashion Week in February, as well as sponsoring NHLBI's heart truth ad campaign. But the authors and comments at The Wall Street Journal Health blog are wondering about the connection between a sweet soda and heart health. http://blogs.wsj.com/health/2008/01/08/hearth-health-goes-better-with-diet-coke/.

So what are the ramifications of having a not-so-healthy beverage sponsoring a health campaign? Advertisers align themselves with certain programming to try and project a certain image. Is the advertiser trying to buy a healthy label by sponsoring a health campaign?

Empathy in cancer care

The New York Times highlighted an article recently published in the Journal of Clinical Oncology. A little bit of empathy can go a long way in helping patients understand and stick with their treatment.

You can find the article here: http://www.nytimes.com/2008/01/08/health/08seco.html?ex=1357448400&en=8203887449e399dc&ei=5124&partner=permalink&exprod=permalink.

And the abstract is here: http://jco.ascopubs.org/cgi/content/abstract/25/36/5748.

This article got my attention because it parallels the research we are doing at MCW about quality communication. Empathy is an important aspect of clinical care. It shows the humanity of the doctor and potentially offers the patient hope. But when patients open up about emotions, doctors rarely engage in the discussion and too often, divert the conversation back to science and medicine. But the good news is that younger doctors and those who identify themselves as socioemotional responded better to emotional cues. Emphasis and training on addressing the emotions of health care will help doctors be better equipped to respond to their patients' emotional, as well as physical needs.

Status careers

This article doesn't really have to do with doctors and communication, but it still caught my eye. The New York Times ran an article about how the traditional status careers - doctors and lawyers - are no longer considered the highest status careers. There has been a cultural shift in defining career success, one that focuses more on creativity and flexibility. Doctors and lawyers are important, staid careers, but they lack creativity, and are certainly not flexible as both careers demand long hours.

You can find the article here: http://www.nytimes.com/2008/01/06/fashion/06professions.html?ex=1357275600&en=e6188de13887a970&ei=5124&partner=permalink&exprod=permalink.

Medicine and law both have high burnout rates and growing levels of professional dissatisfaction. Though there are plenty of reasons for both, I propose that if you are going to go into these careers for the right reason. If you are going to these careers for status, you will not be satisfied. But if you go into these careers because they are what you love, that passion can sustain you through the most demanding days.

therapeutic misconception

The Association for Clinical Research Professionals December Wire reported on a study that many research participants do not understand the difference between research and standard treatment and may be under the misconception that enrolling a clinical trial means they will receive better treatment. You can find the article here: http://newsmanager.commpartners.com/acrpwire/issues/2007-12-31/1.html.

The idea of therapeutic misconception highlights the importance of clear and honest communication between the research coordinator and the research participant. The research staff has an absolute imperative to make sure the patient understands the implications of participating in clinical research, including treatment alternatives. That's what informed consent is all about.

Sharing the benefits of government-funded research

The Wall Street Journal Health blog commented that the spending bill President Bush signed last week included a provision that researchers have long been fighting for: NIH-funded research results need to be posted online, for free, one year after the results are published in an academic journal http://blogs.wsj.com/health/2007/12/27/congress-gives-fda-a-raise-sets-information-free/.

This is an exciting development for researchers. Academic institutions have financial limitations to how many journals and databases to which they can subscribe. Having access to emerging research data from NIH-funded research in a searchable, accessible database will facilitate medical research and encourage collaboration.

Explain and apologize

I am still coming down from the holiday busyness and post-holiday catch-up, but I wanted to share this story from The New York Times. Sandeep Jauhar write a firsthand account of how both admitting medical errors and apologizing for them can enhance the physician-patient relationship and even possibly reduce the risk of litigation. http://www.nytimes.com/2008/01/01/health/views/01case.html?ex=1356843600&en=62133043c42c5595&ei=5124&partner=permalink&exprod=permalink

In the past, legal departments discouraged doctors from admitting mistakes. But many states have created litigation to encourage physicians to disclose mistakes by offering some protection from litigation.

It is important to build trust in the physician-patient relationship and one of the most important elements of trust is honesty. And admitting and apologizing for mistakes is one big step in building an honest communication relationship.