I felt my ire rise when I read this article on CNN about how patients are giving their doctors headaches. Apparently, this video entitled “The Patient Who Knows Too Much”, which is part of a training program aimed at doctors to help them deal with “difficult patients,” has caused quite a stir.

Elizabeth Cohen, my friend and Senior Medical Correspondent at CNN writes about a fictitious patient named “Will,” who is represented by a nerdy-looking avatar holding a laptop computer, peppering his doctor with questions and information he has learned online about his disease. She writes:

In the presentation, three doctors comment on the challenges Will poses.

“They consider themselves an expert yet often their true medical knowledge is quite limited,” says Dr. Joseph Scherger, vice president for primary care at Eisenhower Medical Center in Rancho Mirage, California, who says patients like Will are “indiscriminate” about the material they read online.

“Patients who present their expertise as telling you how to practice medicine are implicitly discounting your expertise,” adds Leonard Haas, a psychologist at University of Utah School of Medicine.

“Sometimes these patients are very overweight. They’re out of shape,” Scherger adds. “They’re on the Internet all the time.”

When I read this, my blood started to boil and I had to do a little loving-kindness meditation aimed at doctors to calm myself down. So I’m about to rant, but hopefully, I’ll be more loving than I would have been a few minutes ago.

You’ve been properly warned.

How Dare They?

Even the title of that video is condescending – the patient who knows too much. After all, how can an empowered patient know too much?

As a physician, I know EXACTLY what kind of patient these doctors are talking about. They show up with ten pages of info they’ve downloaded off the internet, and some of it is from sites of questionable repute, often bordering on, or flat out stepping plainly into, propaganda.

When you’ve got ten minutes with the patient, as the physician, you may feel frustrated having to read, interpret, and explain what they’ve downloaded, especially if it goes against the treatment plan you’ve carefully crafted.

But That’s Your Job, Doc

I’m sorry. No offense, docs. But this is our JOB. We are teachers, healers, educators. It is our JOB to help our patients navigate their medical decisions with compassion, patience, and an open mind.

Our patients know their bodies better than we will ever know. We may have gone to school for a decade to learn about the human body, but we do not live in the body of our patients. Only they have the power to tap into their intuition and know what is best for them. And we are thwarting the process if we get in the way of that self-healing process.

Education Is Empowering

When you are sick – especially when you are sick with a rare disease – you may wind up knowing more about your illness than your doctor does. And more power to ya! It’s your body after all. Your doctor may not have time to go to the library and pull every article ever published about your rare condition, but you may be able to do that, and the internet makes it easier than ever to do so.

This is part of what I do in my medical practice. I work one-on-one with patients in extended sessions helping them navigate the scientific literature, answering their questions about what they’ve read on the internet, doing my own research and translating it into plain language for them in order to help them make the best decisions possible, advocating on their behalf and calling their own physician, if necessary, listening to their intuitive hunches, and empowering them to learn the tools necessary to heal themselves.

This service is desperately needed because so many doctors are dismissive of an empowered patient who wants to fully understand her health condition so she can make the best choice possible for herself.

An Empowered Choice

Take my patient – we’ll call her Eloise – who found out she carried the breast cancer gene (BRCA). The presence of this gene means she has a very high lifetime risk of developing breast cancer or ovarian cancer, so her doctor recommended that she have her breasts, ovaries, and uterus all hacked out.

She was like “Not so fast, buster.”

So we spent hours in sessions together, reviewing the medical literature, reviewing the alternatives, playing every possible scenario out to its best and worst possible outcome, tapping into Eloise’s intuitive wisdom about what was right for her, freeing her from the temptation to agree with her doctor, just so she could please him, and empowering her own self-healing mechanisms.

Eloise is very conservative, with a very low-risk threshold, so she got very clear from our sessions that she wanted to do everything possible to minimize her risk. She didn’t want to spend the rest of her life worrying about getting cancer, so she decided to get her breasts and ovaries removed, but after we reviewed the medical literature together, she chose to keep her uterus, even though her doctor recommended otherwise.

Some doctors might label Eloise as one of those “difficult patients,” who got a second opinion, did her research, and made a choice that differed from what her doctor recommended.

But for me, Eloise is my ideal patient. She abides by the kind of doctor-patient agreement I wrote about here. She’s educated, empowered, and accepting responsibility for her own health, rather than handing her power over to someone else and saying, “Fix me.”

Doctors, who get annoyed by patients who ask questions, second guess them, read stuff on the internet, and make their own decisions based on their own gut instinct, need to get off their high horses and get over themselves.

In Sacred Medicine, all patients will be like Eloise, and health care providers will cherish these kinds of patients who take an active interest in their own health care.

I’m here to lead the way into a vision of the future I see coming closer every day. I’m going to be writing a series of posts about Sacred Medicine, so make sure you’re on my newsletter list to keep up to join the movement and stay in the loop.

Can You See It?

Do you believe it’s good to be an educated patient? Are you gutsy enough to second guess your doctor when your gut tells you to make a different choice? Do you print stuff off the internet and bring it in with you? Do you question your doctor and make sure you understand and feel comfortable and agree with the treatment plan?

Tell me what you think!

Cheering for educated patients,

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4 Comments

  1. Maya Hanley

    I recently had knee surgery. A week later, I saw the surgeon and spoke to him at length about how the knee was and some other surgery I’d had ten years ago on my left knee, to fix the same problem but unlike the current surgery. After a while he asked me what I did for a living and I told him I had my own business etc. He said, ‘Oh, I thought for sure you were in the medical field as you are so well informed’. I told him I appreciated his appreciation and he then said ‘Just don’t get too well informed’ and laughed. I told him not to worry, I wasn’t after his job.

    I found this to be amusing and totally fine and he really was one of the first surgeons I had come across who seemed to appreciate my knowledge and awareness.

    I still find though, that my GP wants to gloss over things and not go into detail so I always leave feeling like I don’t know enough to make an informed decision. I think this is why a lot of people turn to the internet to research. I know I do. I also realise I can’t find out everything in the internet and I value the knowledge and experience of a good doctor.

    In the UK and Ireland you get ten minutes to talk to the GP so it’s hard to get any real answers. I don’t see how a doctor can really do a great job with only ten minutes.

    Reply
  2. Lissa Rankin, MD

    Yeah, it’s very hard Maya, when you don’t have time with patients. Most docs long for more time with patients. The healing process, at its optimal, requires time. It’s part of why the current health care paradigm is so broken. You can write an Rx in 10 minutes, but you can’t facilitate healing…

    Thanks for coming over to the new site!
    Much love
    Lissa

    Reply
  3. Gwen

    Hi Lissa,
    It’s always been refreshing to know you are a Doctor that looks into self healing. I’ve had issues with Doctors. My childhood Doctor, misdiagnosed me for 22 years. It was not until I became a ‘difficult and unruly’ patient that I finally got a correct diagnosis. I was born with a piggy back kidney with 2 tubes coming off and joining to one, so I had refluxing problems all my life. I was diagnosed a hypochondriac at a very young age. Finally that was sorted and I was one of the hospitals fastest recovering patients as I was actually looking forward to, a renal nephrectomy. I found another Doctor after this.
    The latest Doctor has diagnosed me with depression, only to find out 2 months later, what was causing my weight loss and general sadness, was because I was pregnant.
    I have had other minor issues and one day my Doctor said he’d been to a meeting about Marfan syndrome. All of a sudden I’m being told that he thinks I have this. All I said was, ‘well until you confirm this with tests, I’ll take it that I don’t have it until diagnosis has been confirmed’. My Doctor has never gone further with this.
    Once my children were born I looked into and started using alternative medicines and my Doctors visits became less frequent. When my relationship broke down completely with my children’s father, I started going to the Doctor more. Basically he asked ‘are you not doing your homoeopathy and other treatments?’, which I replied, ‘no, not much of late’. He basically said, ‘well you should as I hardly see you then’.
    Also once at the end of a consultation (realising there is not much time to discuss much) I slipped in that I would like some counselling about past issues, did he (my Doctor) know of any good counsellors in out district. He responded, ‘there is plenty in the phone book’, at this time I was on my own with my first child and didn’t even have a phone and we didn’t have mobiles either, so of course I didn’t consider counselling until 15 years later.
    A consultation is 20 mins here.
    My last minor surgery at the Doctors (a locum) had no follow up or after home care advice. I was only given ice packs and one extra pad dressing. I ended up researching the internet to see if my pain threshold was not as good as I had once thought, only to find out the surgery, although performed at the Doctors practice and then sent straight home to carry on with work or what ever, was one of the most painful problems/procedures to get over and recovery was definitely not going to be in a week as I’d anticipated 🙂
    I have pretty much, lost my faith in Doctors here, so it is very refreshing to read your bloggs and to see you come in at it from a completely different angle, the patients view of things. Well done Lissa, I wish there were more Doctors like yourself 🙂
    I’ve educated myself and gutsy enough to say I don’t like this diagnosis without tests, but really it hasn’t got me any further with my Doctor, perhaps more distant. I hadn’t been to a Doctors for over 4 years before my last procedure. My next will be to get a health check, but I’m not even sure how to ask for it as he only likes to discuss one issue per appointment. Yes I brought in ‘a list’ once and was told sternly, only one issue per appt!
    All the best with your new site…I’m sure with just who you are it will be a huge success.
    Love and light

    Reply
  4. Lissa Rankin, MD

    Dear Gwen,
    Thank you so much for sharing your story. I’m sorry for what you’ve experienced at the hands of insensitive doctors and encourage you (I know you will! ) to keep the faith and keep being your own best health advocate.

    Much love
    Lissa

    Reply

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