Radical Transparency: Does the digital age in healthcare require a new Consultation model? | Dr Mayur Vibhuti
Whether we like it or not we are riding the start of a digital wave in healthcare. Technology and social media are changing the way we practise medicine and the way patients interact with healthcare. As clinicians, we no longer have exclusive rights to scientific research and medical theory. Instant answers from Dr Google can give patients access to depths of information they do not necessarily want or understand, but can also empower them to make informed choices about their health.
This is causing strain on both sides of the consulting room. The patient wants to be heard and their opinions validated and the clinician wants to ensure all aspects of evidence based medicine are safely covered and there is an individualised treatment plan. What happens when the so-called ‘patient’s agenda’ does not meet the ‘doctor’s agenda’? Dissatisfaction on both sides. This can lead to unnecessary testing, incidental non-significant findings causing anxiety and sometimes complaints against well-meaning clinicians.
Who should we blame? Is it the doctors for not wanting to change to meet the changing face of public expectation or the over demanding patient who wants to input and influence the outcome of a consultation without the benefit of a medical degree?
Well, I suspect, neither, but we do need to demystify each other’s motives. Perhaps we need to adopt a new model of consultation with more radical transparency. Doctors in primary care are often taught to explore the ideas, concerns and expectations of the patient developed at a time when the patient historically had been in the dark about medical conditions, treatments and tests. Concerns in the past have been skewed by opinions from friends, family and stories of what happened to someone else with the exact same set of symptoms (usually with a bad outcome). What happens then when today you can search the internet and access the stories of millions of people, not to mention forums, support groups and diagnostic algorithms?
Confusion on a global scale. The hierarchy between patient and doctor has become flatter. This is a good thing, but the interaction has to change. Doctors need to be candid about their thought processes and share why they are doing what they are doing. Meanwhile, patients need to be candid about why they are thinking what they are thinking and if either party does not know why – they need to be honest about that too. Only the truth and transparency of thought process will build trust between doctor and patient in the digital age; coupled with the realisation that neither can always have what they want.
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