Knowledge may be power, but is it healing?

The explosion of medical information on the internet is a good thing, right?  Patients worried that their condition is not being taken seriously, those who want a second opinion but are worried about upsetting their GP by asking for it, and those with symptoms too trifling or embarrassing to take to a doctor—all these people who, fifteen years ago, may have felt at a dead end with the medical profession can now use the internet to research their conditions from the comfort of their own homes.

All of this information can be overwhelming, however. In The New York Times, Tara Parker-Pope asks whether patients may be drowning in this sea of information, rather than swimming in it, and offers some tips about how individuals can best make use of it. To summarise, Parker-Pope advises: assess how you respond to information and tailor your research accordingly; if you don’t understand the science, use your research to find someone who does; keep statistics in perspective; don’t just use the web—use your doctor, the library, even take classes; and discuss research with your doctor.

 This is all very well for patients who have a computer, the education to use it to research medical conditions, and the confidence to discuss their findings with their doctor. For everyone else, this increase in patient choice and freedom could be highly unsettling: various writers have remarked that increased choice does not equal increased satisfaction, and often results in the reverse. And, perhaps perversely, there’s a risk that as patients bypass their GPs with their medical queries, their choices might actually decrease. GPs are under constant pressure to balance patient consultations with their other duties, and a reduction in demand from internet-surfing patients could conceivably result in fewer or shorter consultations, and face-to-face support gradually being replaced by web-based resources. This might work for some, but it is highly unlikely to work for all.

 For some patients, taking control of their condition is very important.  These people realise that doctors are not always right, and that a week spent researching a condition can—in certain respects—make a patient more knowledgeable than their doctor. For other patients, however, doctors are scientists, and scientists are always right.  Feeling confident that they are being well looked-after is itself an important part of the healing process [1], and the suggestion that patients should surf the internet to verify the opinions of their GP risks undermining this confidence.

Recovering from a disease or managing a condition is only partly about having the right sort of information.  There are those who treat scientific information with the utmost suspicion when it emerges from anywhere other than the mouth of a scientist (as I found out to my cost as a 15-year-old when, having proudly corrected my grandfather's claim that frozen peas contained no goodness, was told off for talking bloody nonsense).  In the ideal world, we might educate such people about which factors make information reliable.  However, a world in which those potential students are ill, and can benefit more from the care of a possibly-mistaken doctor than they can from internet access and the latest copy of The Lancet, is far from being the ideal world.

[1] Bedside Manner a Placebo Effect? The Scientist 17/3 (10 February 2003): 17