(Jason Lee/Reuters)Can a patient ever show up at the doctor’s office with too much information?
A doctor’s essay about medical “Googlers” — patients who research their symptoms, illness and doctors on the Web before seeking treatment — suggests they can. The report, which appeared in Time magazine, was written by Dr. Scott Haig, an assistant clinical professor of orthopedic surgery at Columbia University College of Physicians and Surgeons. He begins with a description of a patient he calls Susan, who seems to be clicking on a keyboard as she speaks to him on the phone. “I knew she was Googling me,” he writes.
Dr. Haig’s disdain for her information-seeking ways becomes quickly evident. He describes the woman’s child, whom she brings to the office, as “a little monster” and notes that the woman soon “launched into me with a barrage of excruciatingly well-informed questions.” Every doctor knows patients like this, he writes, calling them “brainsuckers.”
Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived. It was a little too much — as if she knew how stinky and snorey I was last Sunday morning. Yes, she was simply researching important aspects of her own health care. Yes, who your surgeon is certainly affects what your surgeon does. But I was unnerved by how she brandished her information, too personal and just too rude on our first meeting.
The problem, Dr. Haig notes, is that patients can have too much information and often don’t have the expertise to make sense of it. “There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore,” Dr. Haig writes.
Dr. Haig’s essay, however, has riled patient advocates, who believe patients need to arm themselves with information and take charge of their own medical care. Mary Shomon, who runs a popular thyroid disease blog on About.com, recently highlighted the essay on her site, generating angry responses from readers. Ms. Shomon said she thinks many physicians like Dr. Haig are threatened by patients who use Google and other Internet resources to research their own health questions.
“By condemning Googlers, he made it clear that he’s threatened by empowered, educated and assertive patients who do their own research,” said Ms. Shomon. “He can’t handle a patient who talks and doesn’t just listen. Good patients…are seen and not heard, right?”
Dr. Haig concludes his essay by confessing that he decided not to treat the woman, whom he described as “the queen of all Googlers.”
I couldn’t even get a word in edgewise. So, I cut her off. I punted. I told her there was nothing I could do differently than her last three orthopedists, but I could refer her to another who might be able to help.
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While doctor’s can be oversensitive when patients come in knowing (or thinking they know) “too much”, Dr. Haig’s problem seemed to be more related to Susan’s rudeness and compulsiveness. Wouldn’t you feel a little put off if some stranger came to a business meeting armed with the knowledge of where you live and accompanied by a rambunctious child? This woman was sending all sorts of red flags that she would be a problem patient and possible stalker - seriously, why would she not only research where he lived, but tell him she knew where he lived at the first interview?
— burntnortonI read the above column and then went to the actual article in Time and found the tone to be somewhat different, as if the above column is a distillation of the doctor’s reaction to Susan with only a little bit of his explanation as to why he felt that way towards her. He says: “Susan had neither the trust of a nurse nor the teachability of an engineer. She would ignore no theory of any culture or any quack, regarding her very common brand of knee pain. On and on she went as I retreated further within. I marveled, sitting there silenced by her diatribe.” What he disdains is less her “information seeking” as stated in the column above but rather the fact that she wouldn’t pause long enough for him to even discuss what he thought of what she was saying. If that description is true, and of course we’re only exposed to Dr. Haig’s side of things in the Time article, then it wasn’t so much that Susan was informed and a challenge to Dr. Haig’s authority as much as she had already made her mind up before she stepped into the office, making the whole visit pointless. Communication is a two way street, whether in a business deal or a courtroom or between spouses, and Dr. Haig also asserts his disdain for patients who just sit down and take whatever the doctor gives them without questions.
— JonasTPP responds: I agree she was an annoying patient. But I find it interesting that medical Googlers are all sort of lumped into one in this article. By choosing this one patient to highlight, don’t you think he is indicting all medical Googlers? No where in the article does he acknowledge that patients should be encouraged to gather information and that some Googling by patients is okay.
The doctor would’ve done better to write his essay focusing on the woman’s difficult personality and intrusive attitude rather than her research on Google, which is, IMHO, invaluable. I recently was waiting to have my gallbladder removed when I developed a weird symptom, one neither my GP nor my surgeon had mentioned to me. I was ready to dismiss it as nothing, but just to be sure, I ran a couple of Google searches. It turned out that symptom could be a sign that the gallstone has choked off the bile duct and is causing liver damage. I called the surgeon with this information, and instead of dismissing me as “an overinformed Googler,” he immediately ordered blood tests done. Sure enough, I was in real trouble with my liver, and we moved my surgery up two weeks. I’m glad I had a doctor who didn’t have an attitude problem about my own research and was able to simply listen to the facts and react accordingly.
— SophiaWhile this particular patient was clearly obnoxious, I know, from personal experience, that individual research can save your life. As a Clergyperson I have participated in the life experience of hundreds of patients. Unfortunately, I have witnessed dozens of misdiagnoses and numerous acts of incompetence in the medical field. I wouldn’t dream of seeing a doctor for a serious condition without acquiring as much information about my symptoms as possible. “Googling” is the smartest thing a patient can do. Doctors are going to have to get used to being second-guessed and paying a bit more attention to their work. They are no longer the gods they used to be.
— Larry E.Considering both the amount Americans have to pay for medical care, as well as the shockingly inept treatment and callous attitudes demonstrated by physicians, “doing one’s homework” is a very wise idea.
Susan may have gone too far in her hectoring interrogation of Dr. Haig, but I don’t feel that her research exceeded the bounds of ethics. I always look at the diplomas to see where my doctor was educated, and would look the same information up online, and if s/he has written a paper, I’m very interested in reading it to see if I can glean any information, either on my condition or on the physician.
Although Susan was wrong to act the way she did (and had I been her doctor, I would have evicted her little brat from my consulting room), Dr. Haig is too high-minded about the practice of patient research.
In this day and age, when the individual seeking medical treatment is held subservient to the insurance company and the medical provider, we are left to our own devices, and doctors should not object to any level of information-gathering on the patient’s part. The beauty of the Internet is that all the information is out there for the taking. The curse of the Internet is identical.
— MattWhat is this, the National Enquirer?
The headline doesn’t really match the story. The Doctor seems to be complaining about one specific patient (with a suggestion that she may be part of a larger group).
He doesn’t seem to be saying that he has a disdain for ALL Googlers. On the contrary, he seems to be saying that some patients (engineers) who know about their ailment and consult with the Doctor are the BEST patients.
— MoonDr. Haig’s article makes me so sad. Sad and angry. It’s not only the air of resentment toward patients or the disdain for their attempts, however annoying, at self-advocacy. Dr. Haig wants to be respected for how he thinks about problems, as indicated by his preference for treating engineers; yet his thinking is remarkably limited. What would happen if he reframed this woman’s problem and saw the potential mental health or cultural implications of her invasive behavior? He recognizes “googlers” are a symptom of something in our society, yet he proposes no solution (other than “punting”) or deeper examination beyond assuming they’re just obnoxious and selfish.
I have no doubt that many patients can be extremely frustrating to work with, but I would expect Dr. Haig to rise above this and strive to find effective ways of dealing with all people that need care.
In the meantime, as experience with doctors has taught me, the hard way, I will continue googling and advocating for myself so I can receive quality health care.
I would hope Dr. Haig would pay attention to the responses his article generates and re-examine why he pursued a medical profession. And if he is unable to redirect the bountiful compassion he has for himself to his patients, maybe he will think about a career change.
And thanks to all those docs that DO listen to and advocate for their patients!
— Mary EberleTyping symptoms into Google doesn’t make you “empowered” or “educated” any more than overhearing stock tips on the subway makes you a stock broker.
— GeorgeWell, now anyone googling Dr. Haig will have access to an essential piece of information– they’ll know that he is threatened by a knowledgable patient. It sounds like he made a lot of judgements about Susan before even meeting her in person. These are not qualities I look for in a doctor, no matter how impressive his/her medical education may be. Perhaps medical schools should train doctors to work with and encourage patients who are engaged in their own health and care.
— new momThere is a difference between quantity and quality of knowledge, and there is a difference between reading a technical article or write-up and understanding what it is about. Patients SHOULD do some research before they visit a doctor, but that doesn’t entitle them to assume they have a medical degree. Aside from the known inaccuracies of a lot of “information” on the Web, medical information has to be taken in the context of medical knowledge, and many medical “facts” are disputed by equally reputable sources.
So research, by all means. But don’t believe everything you read and don’t assume it means you know more than the doctor does. Medical care should be a dialogue. It should not be a monologue in EITHER direction.
— sscheiberI agree. I often read up on a condition I think I may have before going to see a doctor, but I don’t think I’ve ever offended the doctor with my overbearing attitude. It’s the way you present it- of course if you’re belligerent and confrontational, then NO ONE will enjoy working with you. There must be a certain level of deference to the doctor’s knowledge and experience or else, who go see one? Also, finding out where he lived (and letting him know you know!) is way over-the-top! Reading papers he’s written or other deeper research may make sense if you yourself are medically trained and you have a very specific, specialized condition on which this specific doctor has done a lot of research…. otherwise, it’s like the doctor said- you won’t really understand anyway.
It’s this pseudo-expert or “google expert” syndrome that’s really annoying! Not that people go to the doctor and mention something they’ve read and ask the doctor’s opinion, but that they actually believe they know more about medicine from “googling” than the doctor knows from years of study and experience. This actually happens in just about every other field as well these days- I teach martial arts and have students who are the same way….
— dbailaEventually this will get resolved, and here is how (I predict). A bunch of unethical physicians will allow patients to essentially make their own diagnoses off Google, and will give them whatever prescriptions and treatments the patients demand.
Of course, the inevitable tragedies will follow. Then, there will be malpractice lawsuits and press exposes. People will finally clue in on the truth of what Dr. Haig is saying: “The expert knows what to ignore.” But not until the tragedies have occurred, unfortunately.
— corinneIn answer to burntnorton’s question: She’s rude because she’s AFRAID. How is it possible that doctors don’t understand that patients feel helpless in the face of their disease and an impersonal, uncaring health system? Why did this Dr. Haig get into medicine? How dare he regard a patient (child or not) as a “little monster”? And if he thinks it’s rough for a patient to know what his address is — try being touched everywhere on your body by strangers. Not just one stranger, but by many, when you’re in the hospital, some of whose names you don’t know. Dr. Haig, quit your job. Do something in a field where your attitude won’t hurt anyone. If you were lying when you said your expertise couldn’t help her, I wonder how you sleep at night.
— Exhausted patientAside from the plain rudeness factor, there is something to be said about people who try to essentially one-up their physicians about whatever ails them. While it is smart to be aware of risks attendant in any procedure and alternate paths that may be available, ultimately we go to a doctor because we need a judgment call by someone who spent years in school and perhaps decades in practice.
Going in with the notion that you can be an equal to the doctor’s expertise with a Google search seems hubristic and dangerous.
— KennethI used to do a lot of googling about any illness or injury I had and flooded doctors with questions. I think learning how to just read your doctor is more effective than interrogating him. I am fortunate to have a doctor who knows what he is doing and I am put my faith in him that he will do the right thing.
— NickGranted, a woman who has gone through three orthopedists and is seeing a fourth is probably not the easiest customer to please and I don’t doubt that she may have been quite rude; a lot of people are when it comes to important stuff like health. On the other hand, the fact that a doctor describes a patient’s questions as “excruciatingly well-informed” is pretty troubling. There’s a great episode of an old show with James Burk called the Day the Universe Changed on the excessive blind obedience that is common in the modern doctor-patient relationship. Any source of information that can break that unfortunate trend is a good thing for patients and doctors, even if it does cause a rude exchange every now and then. Sounds like Haig just needs to grow some thicker skin.
— RussellAny reasonable person knows that there is a difference between an educated patient and a wackjob.
— LGI don’t think “threatened by empowered, educated and assertive patients” are the problem here. The problem that Dr. Haig has is with the uneducated and assertive attempting to do his job and unfortunately failing in ways they have little comprehension of. Let’s say you are a welder, an engineer, a secretary or a scientist…how would you like your customer helping you choose the right tool, adjusting your measurements, spell checking your dictation for you or pipetting your buffers for you? This is EXACTLY what this woman did to Dr. Haig and it is unacceptable. Read up on your symptoms and even DISCUSS when you’ve come across some treatment that you’d like the doctor to consider but make sure you keep in mind that this professional is well-trained and deserves more respect than “Susan” offered.
— Sean SerraguardI actually read the essay, and it’s too bad the rest of the quote wasn’t repeated above:
“There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore.”
There’s a massive difference between the informed patient and the expert practitioner. One of the most important things we as patients have to do, even if we’re doctors ourselves, when seeing other doctors and specialists, is be the patient and not the practitioner. If you are so absorbed in what you think is right, you have no space left for alternative opinions, and more importantly, expert opinions. You are not that specialist, it is not your job day in and day out, and experiencing your personal symptoms and looking up information online does not replace intensive education that never actually ends and constant professional practice.
If you don’t like the opinion, get another one, but remember that just because you hold it doesn’t make it right.
— LauraOne of the skills an effective clinician needs these days is information management.
— A.Snaiderman,MD,FRCPCHow to triage the information he gets exposed to from both academic and lay sources, as well as the information (good and bad) the patient brings to the medical setting. Clinicians should know how to help the patient understand the information they gather and to put it in context and perspective.
I personally prefer a patient who has taken the time to get informed as oppossed to a passive one.
The problem Dr.Haig’s patient had would have presented itself with and without Google.
Compulsivity by definition is based on anxiety and trust issues. It does not require the internet.
I agree that it was not the woman’s knowledge gleaned from Googling that seemed to be the problem with this patient, but rather her personality problems, even, shall we say, her personality disorder?. Dr’ Haig never even mentions any information she has learned about her actual disorder, only info about himself. However, if you read the original article, there are many other disturbing characterizations in Dr. Haig’s article. For example, what he says about nurses. Since he’s into quick dismissive remarks about others, I have two for him. 1) He sounds like he has the typical people skills of a surgeon, and 2) I’ve never found it easy to respect a doctor who calls himself a “doc”.
— Lyra S. Ward PhDAs a massage therapist, I sometimes see new clients who aggressively demand a specific type of treatment– even though that treatment may not be appropriate for their condition. I recognize that this pushy behavior, though off-putting, is usually the result of a person’s need for education and reassurance. They want to know that I am capable of helping them feel better. Once I have explained the reasoning behind my recommendations for their treatment, people inevitably become much more relaxed and trusting. Susan sounds like a parent who wants the best for her child. Had Dr. Haig taken the time to explain his thoughts to her and to address her questions and concerns in a respectful way, he might have had a more successful interaction.
— newmomIf doctors actually spent more than 5 minutes per patient then I don’t think people would need to do their own research beforehand. The problem is most doctors don’t listen, don’t do a thorough diagnosis, and just prescribe antibiotics for any problem. If the patient needs to return, then all the better to rack up more fees.
And how about some empathy? If your kid was sick, wouldn’t you also ask some “excruciatingly well-informed questions?” I guess if your child dies, oh well?
— EdLike Dr. Haig I am also a surgeon and I would not treat this woman, but for slightly different reasons. Her manner and method of sharing the information she found is the problem. She sounds rude, contentious, abrasive..just the kind of patient who will never be satisfied and more likely to seek legal recourse should something not go her way. It was smart of Dr. Haig to turn her away. Patients like her are not worth the trouble it takes to treat them.
— surgeon mdI’m a physician. I use google often and I fully support the well informed patient. But as stated in #1, there were additional issues beyond the patient’s knowledge base.
— DaveThe concern that I have about the well informed patient is that from a handful of good and solid facts gleaned from external sources; patients tend to extrapolate all the knowledge learned from medical, residency and fellowship training. I often spend time unlearning the patient as to why something doesn’t apply in this situation.