The Armchair Physician: Challenging Patients You’ve Known Too Well, Part 3
The public has an impressive number of informative sources when it comes to their healthcare, so that means medical professionals should have an easy time treating them, right? Well, not exactly. The problem with those sources is that they aren't always well-researched, peer-reviewed journal pieces, and even if they are, healthcare consumers sometimes lacks appropriate professional context to understand them. If you find yourself with one of these patients in your office, chances are you're dealing with The Armchair Physician—a patient already burdened with the typical worries and concerns that have been tuned to a fever pitch through their own research. Here's how to address their needs while avoiding becoming an unwilling authority for their confirmation bias.
Be Aware of False Information
The old line about knowing your enemy holds true, here—knowledge is the first line of defense when it comes to gently correcting an Armchair Physician on a roll. Posters, illustrations and charts will help support the facts you're explaining, so try to keep them close by or accessible, if at all possible. Be cautious about broaching the subject, as well. As Doctor Rami Hashish explains on DignityHealth, it's important that you’re delicate in your corrections. Your patient has potentially had days to "get used" to their incorrect self-diagnosis, so trying to bully them into the correct one may lead to a communication breakdown or even resentment on their part.
If possible, work to put correct data where your patients can access it to mitigate misinformation. Some hospitals and clinics have already started using online chat features to start patients out with realistic expectations for pre-diagnosis.
Be Prepared for Confrontation
The internet, with its wealth of questionable health diagnosis techniques, is only a pocket away in the age of smartphones. It's likely only a matter of time before a Millennial patient’s characteristic tech-dependence kicks in and a screen is thrust at you in defense of an incorrect self-diagnosis. Diagnostic websites and tools—some sanctioned by insurance agencies, others not—add an air of authority to a result. The problem is that just about any result will look conclusive to someone who has been using a symptom checker to frantically search for answers, rather than its intended purpose as simple guidelines and ideas to be discussed with and ultimately weighed on by a medical professional.
Martha Bebinger of Kaiser Health News echoes what's typically found in the disclaimers beneath these online tools: they are definitely not a replacement for a physician, especially one who understands your case as a whole. If a "diagnosis" is presented as fact before your examination has even begun, remind your patient that any online diagnostic tool is very limited in scope and can't incorporate lifestyle factors or unobserved symptoms the way you are able to.
Empower Them Correctly
The Armchair Physician often believes that unless they're calling the shots on nearly every medical decision, they're not taking responsibility for their healthcare. This back-and-forth can limit the progression made with treatment, bogging it down in a medical version of "Mother May I." Patients should always feel comfortable voicing concerns and asking questions—even about poor or controversial healthcare decisions like opting not to vaccinate—so that you can build trust and help your patients make the right choices. If need be, reassure your patient that he or she will always receive information about their options, if requested, and ask what you can do for them to help facilitate trust and automate some basic processes.
c2b solutions has identified five psychographic segments based on the way healthcare consumers approach health and wellness. These different segments are hardwired with unique attitudes and motivations, and two of these segments – Balance Seekers and Willful Endurers – are more likely than the other segments to take an independent approach to their healthcare, and challenge a clinician’s advice. However, these two segments are polar opposites in their wellness-orientation (Balance Seekers are very proactive and engaged in wellness, while Willful Endurers are reactive and disengaged), so a clinician cannot assume that the Armchair Physician can be approached in the exact same manner. Each segment has its own communication preferences and motivations.
Slate's Theresa McPhail notes that it's still important to acknowledge the fact-finding and research patients do in pursuit of their own care. Again, they might have had days to familiarize themselves with that information and they'll need to be "talked off the ledge." As Jeffrey Kluger points out in Time, even anti-vaccination parents deserve some measure of praise for getting involved in their child's healthcare.
Medicine and younger healthcare consumers’ tech savvy can be an excellent combination, with reasoned responses all around, provided respect and communication are the first prescription for both sides. If you find yourself with an Armchair Physician on your hands, help guide them to the path of informed self-advocacy with these tips, and work with them to build a foundation for healthcare in years to come.