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Click This, Not That: Talking to Patients About Reliable Online Health Information

Danielle JonesMost physicians agree that we have an ethical obligation to help educate our patients about what’s going on with their health, but what does that look like in a world overwhelmed with digital health information? And how do we budget appropriate time when we’re already struggling to balance shorter appointment times, more documentation requirements and busier clinic schedules?

It’s estimated that 72 percent of patients get a majority of their health information online. With an abundance of biased and incorrect information on the internet, our responsibility as physicians has evolved from simply teaching patients about their health conditions to now include educating patients on where and how to find and identify reliable health information.

This premise goes back to why I use social media. We have a responsibility to share, or at the very least be cognizant of, reliable health information in the realm where our patients seek it. In the olden days that looked like an exam room; today it looks like a Google search.

Here are four ways to efficiently help ensure patients have the resources they need to find reliable health information, despite cramped clinic visits and time constraints.

  • Ask: How can you possibly know where patients find their information if you don’t ask? I have patients come in with birth plans all the time and quite frequently they’ve printed them out from a website with little-to-no additional research into the (often very specific) things they’ve requested. You can’t possibly know or understand their views unless you ask.
  • Take 2: I understand how limited our time is. I’m a resident with a busy clinic and short, often over-booked appointment slots, but taking two minutes to discuss reliable health information with your patients has great potential for improving patient care and decreasing un-needed visits and calls.
  • Prep: Have pre-written, condition-specific information for your patients and include curated links to additional reliable information for those who may want it. It’s as simple as a “dot-phrase” on most major EMR systems or a copy/paste file you can quickly email or print.
  • Encourage: Encourage your patients to take control of their health by being informed. Encourage them to ask questions and explain things back to you, so you’re certain they have a grasp on it. Encourage them to share what they’ve learned in their searches.

    Danielle Jones, MD is a a fellow of The American Resident Project, where this post first appeared. Danielle  went to college at Texas A&M University (Gig ‘Em Aggies!) and completed her medical school at Texas Tech. Dr. Jones is interested in fertility medicine, social media and health technology. Currently, Dr. Jones is an Ob/Gyn resident in Texas, where she lives with her husband, twin baby girls and three crazy dogs

Growing Up in the Era of Work-Hour Restrictions

Danielle Jones

In 2008, the IOM study on resident work hours came out and in the years that followed the Accreditation Council for Graduate Medical Education (ACGME) subsequently implemented a gamut of “recommendations.”

As a medical student, I remember thinking it was a much needed change – why wouldn’t it be a good idea to improve patient safety and decrease resident fatigue?

Alas, as a newly minted intern growing up in the era of work-hour regulations, it’s become apparent that many of these changes may actually make life harder without achieving their main goal of improving patient care.

The 80-hour work week cap is fine; it’s been in effect on its own since 2003 and overall it seems to have made residency more humane. Most programs have found reasonable ways to limit work hours to this full-time-times-two amount, at least when hours are averaged over four-week periods.

However, the additional bullet point “recommendations” from 2010 seem to play out very differently in real life than they do on paper. Many of them seem to be arbitrary lines drawn in political sands hiding behind a facade of patient safety, but that’s another blog for another time.

So, what do the bullet point regulations look like in the hospital?

They look like: Interns can’t work 24-hour shifts. 

So, what used to be a two-and-a-half shift weekend turns into a four shift weekend. At a four intern/year program like mine, that means instead of two people splitting the weekends and having a post-call day after 24 hours on, one intern is committed to night-float six nights/week for a month while the remaining three interns take the three leftover weekend shifts.

The result: Fewer hours at a time in the hospital, but more working days in a row and more days/month away from your family.

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