Yes, it's annoying... so what?

I had 2 medical students with me yesterday at my cystoscopy clinic. One of them raised an interesting point about Internet-savvy patients.

One of the patients about to undergo cystoscopy had done some homework. She had Googled "cystoscopy" and read up on the procedure and possible complications. She had also spoken to some family members who told her about other complications (including some that just weren't applicable to the cystoscopy procedure).

We talked about the cystoscopy and some common complications like blood in the urine, burning urination for a short time afterward and the small chance of getting a bladder infection. I also corrected some misconceptions she had about the procedure and possible adverse events. The procedure went fine.

Afterward, one of my students commented that it must be annoying to have people research a medical condition or procedure, but not really have the background, education or context to let them understand which information is accurate or pertinent, and which information is misleading.

I know exactly what she means. I admit to having cringed mentally when someone arrives for a consultation, hauling a file folder full of print-outs, cross-referenced with colored Post-it notes. But, I'm learning to use a mental trick to approach such a situation more positively (see the post "Switch" in my Advanced Access blog.)

After all, my job is to gather and interpret information for people. Being a surgeon, I also do procedures and operations, but any physician's main job is to be a data processor. And, I should be doing it in a way that makes sense to my patient and helps advance their understanding of their condition.

It really should be the patient's choice. Sometimes that means a 77-year-old retired farmer telling me "You're the doctor. Just do what you think is best." Other times, it means spending an hour with a 50-year-old business man reviewing the latest studies on how to treat his enlarged prostate.

My main point was: Embrace the idea of an informed patient. When someone walks into your office with reams of research, tell yourself "Great! Here's someone who's interested in their own health. They trust me to help them wade through the thicket of information that is the Internet." Be prepared to schedule an additional visit so that neither of you feels rushed. Don't be alarmed if you don't have all the answers to their questions ("specialist" doesn't mean omniscient). It's more important to know how to find the answers.

It looks like the Internet is here to stay. Better get used to it, doc.