The irony of medical training is you probably talk to other patients more about their health than you focus on your own. In residency, it is easy to get swept up on hours in the hospital and sleep sacrificed for the sake of education. And yet at some point you find yourself in clinic, trying to explain that antibiotics will not help their cold or the flu shot is not going to give them the flu. We have the medical knowledge and training, so why does it become so frustrating when patients disregard what we say?
After a fall off a ladder during an obstacle course, I found myself with a torn ACL and meniscus. As someone who never really interacted much with health care as a patient, I was now staring at a surgery and months of physical therapy. This experience opened my eyes to the structure of the health care system as it impacts the patient's experience and contributes to medical misinformation.
The health care industry is complicated and messy, resulting in a lot of the decisions put directly onto the patient. You would typically want the best surgeon, but you have to do your own research and call around, potentially ending up on a months-long waitlist. You want the fastest MRI but you have to know what facilities accept your insurance and what their next appointment is. You need physical therapy but you aren’t sure which ones are trained specifically for orthopaedic injuries. But now you also can’t drive yourself so how do you make it to your appointments? Even as someone who works in inpatient and outpatient settings, I found myself completely overwhelmed. People who have no medical background or limited resources can be easily just as lost. So where do they turn to? The internet. Filled with vast amounts of information that can be helpful or hurtful.
The importance of good communication is stressed in training, but it really does make a difference to the patient. At the end of the day, regardless of my career, my goal is to prioritize my health. At my appointments, the physician would cover a bunch of information quickly. Something I am guilty of in my own clinic. But I learned if I didn’t write it all down, I would forget parts of it. The appointments would go fast and I realized I would have more questions than what I started with. I began to make lists of questions and topics I wanted to cover because every minute of information gathered counts when an appointment is only 15-20 minutes long. I tried to document everything so I could keep track of all my medications, ward off any complications, and understand what my next steps were.
All this stemmed from my main emotion throughout this process: fear. I was scared. While I had medical knowledge, orthopaedic surgery is not within my wheelhouse. I have seen intubations go wrong and post-op complications come into my ED. Now I was about to put myself through an intense surgery and post-op recovery. I found myself combing through the research to understand which graft choice had the best outcomes or what my post-op physical therapy limitations would be. But I also found myself on Reddit and Google, desperate for as much information as possible. While finding helpful information and connecting with people in similar situations, I also found a vast amount of misinformation, some of which I found myself falling for, even with my medical knowledge. Maybe if I buy this supplement, it will help my recovery. The power of misinformation is as strong as the company’s marketing plan. The misinformation epidemic is spreading but I’ve realized it’s not coming from a place of defiance; it’s coming from a place of fear. We created a complex and intricate health care system with ultra specialists, third party insurances, and a flood of information that we expect patients to be completely on board for. We try to offer resources and not inundate patients with overwhelming information, but the system leaves gaps which patients will try to fill in themselves.
By spending more time communicating with patients and empowering them to ask questions to understand their health, it helps with relationship building and trust. I have a whole spiel now about how to manage knee injuries at home that I share with patients, so they truly know what to expect. It’s important to recognize that with the internet, everyone can give their medical advice. While we still need to combat misinformation, we can start with the patient in front of us, guiding them to proper resources and listen to their concerns. Our role is to advocate for them on their behalf in a system that is not designed perfectly for them.
Dr. Christina Brown is a PGY-4 resident in emergency medicine-internal medicine at ChristianaCare in Newark, DE.
Illustration by April Brust
