Here we are, ten years later, and it's same story, second verse. We have orthopedic surgeon and Time magazine writer Scott Haig, who has written an article, titled "When the Patient is a Googler," which you can read online at the Time magazine site.
Haig may use the term "Googler," and the hapless doctor I saw may say "petit papier" patient, but it's the same. They're just code words for an "empowered, well-informed patient." And even if the terms are different, one thing hasn't changed in ten years: Some doctors don't like us.
Another thing that hasn't changed in ten years: getting good health care still depends on your being a Googler or petit papier patient. Haig's article proves it!
In his essay, Haig makes an example of his patient Susan, who in his view is clearly an archetypal "Googler." Haig depicts Susan as rude, nosey, and overprepared for her appointment. She brings her uncontrollable, disruptive and destructive three-year old toddler -- the "little monster" according to Haig -- to the appointment. According to Haig, Susan launches into him "with a barrage of excruciatingly well-informed questions," and talks so much he can't even get in a word in edgewise. According to Haig, Googlers like Susan are "suspicious and distrustful, their pressured sentences burst with misused, mispronounced words and half-baked ideas." Haig declares that "her complete and utter selfishness was nearly a thing of beauty." Haig bemoans the fact that "Susan had neither the trust of a nurse nor the teachability of an engineer."
After reading Haig's essay, there's no doubt that Haig finds patients like Susan extremely difficult, so difficult, in fact, that he admits that he "punted," and referred her to another doctor, primarily, it seems, to get rid of her.
Now I don't know Dr. Haig. Maybe he's a great doctor, maybe he's not. Maybe he has a charming bedside manner when he's not aggravated by patients, or maybe he's an equal opportunity curmudgeon. But his essay is quite revealing. Because if Susan is a perfect example of the nightmare "Googler" patient, then Haig has depicted himself as the perfect example of the "Empowerment-Phobic" doctor. The arrogant, derisive, and dismissive tone of this entire essay -- and his choosing a patient like "Susan" to represent a "Googler" -- is, sadly, illustrative of the destructive way some doctors actually view their patients.
Susan would be annoying to most doctors, but Haig chose to highlight her for a reason. He wants to make a case that "Googlers" are irritating. Haig, like many doctors, is making it clear that he doesn't want Googlers -- and not just talkative ones with misbehaving toddlers. By condemning "Googlers," he made it clear that he's threatened by empowered, educated and assertive patients who do their own research. He can't handle a patient who talks and doesn't just listen. Good patients -- and toddlers -- are seen and not heard, right?
And this is why, in this essay, Haig actually makes the case even more for why we must do our own research -- why every patient needs to be a "Googler."
Why Should You Do Your Own Research?
1. Research is critical in order to find a doctor who is a good fit for you.
It's easy to find a list of doctors who belong to a professional organization, or who are lauded in your local magazine's "Best Doctors" issue. What's not easy is to find a doctor who not only has technical competence and credentials, but the communications and practice style that will best serve you. So ask -- ask other doctors, ask nurses, ask friends and family, ask online support groups and listservs -- and ask about the doctor's style, personality, and attitudes. Read articles the doctor may have written, check out media interviews the doctor has given. If the doctor has a web site, take a look at it. If the doctor is a professor, go look at his or her university web page. Ask other patients. Readers frequently write to me, shocked, after discovering the hard way that some of the most highly credentialed physicians and self-proclaimed experts from academia and medical societies actually have a dreadful bedside manner and deplorable people skills. Don't make the same mistake!
2. Doing your own research may be the only way you get answers.
Haig says: "Every doctor knows patients like this. They're called 'brainsuckers.' By the time they come in, they've visited many other docs already— somehow unable to stick with any of them. They have many complaints, which rarely translate to hard findings on any objective tests."
What Haig calls "brainsuckers," I call empowered, informed -- and often misdiagnosed -- patients. The reality is that many patients do have to visit more than one doctor. Why?
- Because some doctors rush through appointments, and don't have enough time to do a proper examination and diagnosis
- Because some doctors lack the skills, knowledge or patience to make a more complicated, subtle diagnosis
- Because some doctors routinely misdiagnose women's symptoms like fatigue, depression and weight gain as mental health problems, rather than evaluating for other medical conditions
- Because some doctors -- and especially as we see in the case of thyroid disease -- can't even agree on how to interpret the so-called "objective tests"
3. Doing your own research may be the only way to find out what your doctor isn't telling you.
Doctors can all-too-easily fall into a pattern of providing cookie-cutter diagnosis and treatment. This is very common in thyroid disease, for example, where many doctors follow a formula: "Diagnose using a TSH test, .5 to 5.0 is the normal reference range, give RAI for hyperthyroidism if TSH is below .5, give Synthroid for hypothyroidism if TSH is above 5.0." It doesn't exactly require much advanced education to follow that simplistic view of thyroid diagnosis and treatment, yet this is exactly what you'll get from many "experts." You'll never hear that there is disagreement among endocrinologists about the normal reference range for the TSH test, you'll never hear about the use of supplemental T3 drugs, you may never even know that there is more than one brand of thyroid medication! But if you've done your research, you'll know all this, and much more, and you'll be prepared to find the doctors who can work with you, and answer the questions that will help you achieve greater wellness.
Many doctors are also under the influence of pharmaceutical and medical manufacturers, and tacitly, or unknowingly, edit the information they give you, based on that influence. Only by doing your own research and homework can you find out what the drug companies -- and by association, some doctors -- may not want you to know.
Dr. Haig may not want Googlers for patients. But Haig and doctors like him need to realize that many patients feel equally strongly about not wanting an "Empowerment-Phobic" doctor. Patients are partners -- not subordinates -- in health care, and it's time for some doctors to get their heads out of the sand.
- Check out Tara Parker-Pope's post on this at her New York Times "Well" health blog
- I've written a letter to the editor of Time magazine regarding this article. Read my letter now.
- Poll: Do you think being a Googler or a Petit Papier Patient helps you get better health care? Take my poll now!
- Talk About It! Attention Googlers and Petit Papier Patients: Share your thoughts on this article at the Thyroid Forum now!