Physicians

A patient’s perspective: Do doctors read?

After monitoring e-patients.net and The Health Care Blog, I have to ask: Do doctors read? And if so, what?

I know four things from my own experience (and watching “Grey’s Anatomy”).

First, physicians are busy often exhausted individuals who deal with life-and-death matters.  For some, a robust sense of importance, if not their institutional setting, makes them deaf to patient input. The work-to-the-max ethic and lifestyle is inculcated since before medical school.

Second, physicians in my daughter’s chain of medical events were highly resistant if not resentful of patient input regarding new sources of information, from medical to newspaper to Internet articles. Regardless of how tactfully the material was presented.

Third, as is clear from my own posts, the ones I encountered don’t read The New York Times.

Fourth, the doctors I know, when they do have leisure time, spend it at the health club, on the ski slopes, at the theater or flying jets. They don’t read for leisure and thus are unlikely to familiarize themselves with the irony, say, of Robert B. Parker’s Spenser novels. Irony is useful here in that it, and the humor in Spenser, arises from the skepticism of a Single Joe dealing with large, but not efficient, corporate and government entities.

So I raise the question: Do doctors read? And if so, what?

Whatever they are reading, or not reading, seems to contribute to the ossification of attitude implicit in David Kibbe’s recent post on The Health Care Blog about his quest to urge physicians to adopt up-to-date Information Technology.  Of all the entities involved in transformation of the health care system, the physician community seems least able to adapt to changing times.

Christine Gray is a patient who blogs at e-patients.net, where this post first appeared.

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Cheap Windows 7chrisBruceDoug D (FL)Christine Gray Recent comment authors
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Cheap Windows 7
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Cheap Windows 7

My brother suggested I would possibly like this blog. He used to be entirely right. This post actually made my day. You cann’t imagine just how a lot time I had spent for this info! Thanks!

chris
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chris

I believe what many of the above posts fail to consider is that EVERY doctor is putting their professional career at stake with EVERY decision they make regarding a patient’s treatment. Be realistic, if you had spent 12 years after high school training just to BEGIN to make enough money to live comfortably, which would put you at least 30 years of age, would you not hesitate to risk all of that work, all of those years spent studying and sleeping for three hours (sometimes, in fact often, less) a night, on a patient’s recommendation for treatment? I have an… Read more »

Christine Gray
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Christine Gray

Doug, Thanks. I really appreciate your thoughts AND the time you spent in thinking them:) Check out the more recent commentaries on the Kibbe discussion. We may have been examining the wrong part of the elephant in terms of physician frustration with IT (no hind end of elephant jokes please), time/profit etc. It doesn’t address the point of how well physicians listen to something relevant but outside of their own experience — in some circles that might be called new ideas 🙂 — but coming at the problem from another angle (ditto above) might help reframe the problem. Some basic… Read more »

Christine Gray
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Christine Gray

Nuts to this. I have to fly to NY on business so I won’t be able to play for a while. But keep checking in. The more physicians talk back about the conditions of their lives, and how they feel about things (that would be the F-word), the more patients can learn. Meanwhile, check out a Sara Paretsky mystery novel (the early ones), if nothing else, to imagine yourself in the position of educated patient-advocate (yourself in female dress). I warn you: Get a gun in case someone calls you “the mom” when they’ve lost a record, or have half… Read more »

Deron S.
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I don’t know about all of you, but I am anxiously awaiting Christine’s response. I even made popcorn! But seriously, these discussions really need context. We all sound like a bunch of know-it-alls when none of us really knows the half of it. Our healthcare system has deep multi-dimensional problems that span the various stakeholder classes. If there were easy answers, we would have figured this out by now. We could easily compile a list of the various stakeholders and the things each could contribute to meaningful reform. We’re already talking about these things! The tragedy is the fact that… Read more »

Doug D (FL)
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Doug D (FL)

I did not mean to IN ANY WAY IMPLY, by commenting only the underlying time/money dimension to the problem, that any of the information/power/gender/openness-to-other-ideas central issues of this discussion aren’t (a) real and (b) terribly important. I just don’t have great expertise or good solutions for them. If this is Rock Soup, I have one onion to add to the pot. And I don’t hear much of anybody disagreeing with any of what you’re saying. I’m certainly not. But I’m reluctant to back away from the core of my contributory onion, that any proposed solutions for any of the many… Read more »

Christine Gray
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Christine Gray

This post raises a really important point about physicians’ time.// No. It raises a point about physician and institutional ineptitude and a dysfunctional and outmoded notions of information exchange which male physicians in particular seem reluctant to address. //But I hadn’t seen anything that really focused a flashlight on the underlying tension in the patient/physician relationship that time-based reimbursement inherently introduces.// Check out the Kibbe conversation. The tension in these relations is more than a function of time. That is Kibbe’s warning: the patient and e-patient communities are outstripping physicians in terms of innovation and demand for change. They are… Read more »

Doug D (FL)
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Doug D (FL)

Christine Gray wrote: “Otherwise, you miss the point entirely. When does the physician pay ME for educating him? What is your response to the specific questions? Is it impossible to emphathize with a patient perspective ….” I didn’t address any of those because I didn’t think I had anything useful to add to the conversation in those areas. But I hadn’t seen anything that really focused a flashlight on the underlying tension in the patient/physician relationship that time-based reimbursement inherently introduces. (And remember, in the “business of health care” environment we have today in the US, each physician practice, whether… Read more »

Deron S.
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Christine – I’m certainly not claiming that physicians are not playing a role in our healthcare system woes. As reform takes shape, physicians will have to own up to their shortcomings just as insurance companies, patients, the government will. If spoken about that a lot in my blog. However some of the generalizations made here are irresponsible and counter productive. I also don’t think physicians should have to read NY Times to get their information. There needs to be a standard decision support tool that they can refer to so that they’re not forced to look in several locations to… Read more »

christine gray
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christine gray

and the elephant in the room? And the fundamental questions raised?

Deron S.
Guest

Bruce – The generalizations you make are irresponsible at best. Trying to convince people that all doctors are arrogant, resistent to change and sexist while hiding behind your computer screen is cowardly. Instead of adding something productive, you are taking away from the conversation by adding tension and blame when there is already enough of that to go around.

Christine Gray
Guest
Christine Gray

Doug, Thanks for your input. Patients need to hear about the reimbursement issues to be better consumers. Physicians need to build in a hierarchy of educators. My daughter and I never waste the oncologist’s time. Communication goes through the oncology nurse, who directs the flow of information. Otherwise, you miss the point entirely. When does the physician pay ME for educating him? What is your response to the specific questions? Is it impossible to emphathize with a patient perspective apart from assessing profit-taking potential, which is the point of the commentary on David Kibbe’s “Confessions . . . “? And… Read more »

Bruce
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Bruce

Comments defending doctor ignorance and arrogance are absurd.
Doctors are indeed resistant to patient input of any kind, and to new information.
The claim of time shortage is specious as doctors in grossly lucrative cash fields, like fertility, plastic surgery, have the same arrogant and rigid stance.
God help the informed patient, especially if that patient is a woman, as many male doctors are especially threatened by an intelligent female patient.

Bruce
Guest
Bruce

Comments defending doctor ignorance and arrogance are absurd.
Doctors are indeed resistant to patient input of any kind, and to new information.
The claim of time shortage is specious as doctors in grossly lucrative cash fields, like fertility, plastic surgery, have the same arrogant and rigid stance.
God help the informed patient, especially if that patient is a woman, as many male doctors are especially threatened by an intelligent female patient.

Doug D (FL)
Guest
Doug D (FL)

This re-reminds me that a number of health care reform efforts are based on a transparency philosophy, that the free-market purchasing decisions of informed & educated h/c consumers who bear a substantial personal burden of their consumption decisions will drive cost and quality improvements in health care. And in policy debates, very little has been said about the likely “equal & opposite” result of a growth of patient demand for more give&take interactivity and information transfer during the patient(or parent) and physician encounter. At their heart, all fee-for-service reimbursement schemes for physicians are based on time units … based on… Read more »