Today my wife went out to move my car and came back to tell me that my battery was dead. This is a common thing in Las Vegas since it’s so dry it kills batteries regularly. However, I was intrigued that my wife with no training as a mechanic had diagnosed the health of my car and rendered a diagnosis. I’ll be going to check that indeed it’s the case. If jumping my car doesn’t last, then I’ll have to take the battery in where they’ll run the battery tester to confirm her diagnosis.
When I take the battery in, the mechanic won’t question my diagnosis. He won’t feel like I haven’t trained long enough to know if the battery might be the problem. He’ll run the tests to verify what I’m saying, but he’ll work collaboratively with me to fix the problem.
Why is it so different in healthcare?
In reality, it’s not that different. We’ve been self-diagnosing in healthcare for a long time. There’s a whole industry of over the counter medications that anyone can go and take to treat their health condition with no doctor involvement at all. We self diagnose and self treat with no intervention from the doctor at all. Why then do so many doctors (not all of them) balk at the idea of the patient working to understand their issue and identify their diagnosis?
I think there’s two reasons that this scares doctors. First, a minority of patients have ruined it for the rest of us. Some patients go into their doctor and are completely disrespectful. They treat the doctor as someone who should just give them whatever they want and whatever they ask for. It’s shameful and a few of these “bad apples” will no doubt make a doctor gun shy when the next patient comes in respectfully talking about their own efforts to diagnose their issues. We can’t let a few bad apples spoil the bunch.
Second, the tools we have available today have opened up so many new worlds for patients to be able to be more informed about possible health issues. This starts with Dr. Google which is literally available to us at our fingertips or even at our beck and call (ie. Siri, Alexa, Google, and Galaxy). It continues with this wave of health sensors and health apps which help us better understand our own health and possible health issues we may be experiencing. Both of these are only going to get better. Before we might diagnose a fever but with new technologies we might eventually be able to know if we have diabetes or some other more complex disease. It’s not hard to see how patients will know more than doctors about their own individual health. This is scary, because with increased information and data we can do so much more. However, with that power also comes new risks.
Going back to the car analogy. A dead battery is something pretty easy to diagnose in a car. I’ve even had enough experience with cars that I could probably diagnose an alternator problem. However, while I could diagnose the problem, I certainly am not capable of fixing the problem. Plus, it’s possible that the mechanic might replace the alternator and there are still problems or I might suggest that it’s a problem with the alternator, but they find something else which is really causing the problem because they understand how a car works better than me.
We’re going to find a very similar experience in healthcare. We may be able to eventually know that we’re a diabetic, but we’ll need the healthcare system and doctors working collaboratively with us to actually fix the problem. Plus, we may think we’re a diabetic, but once we see the doctor we’ll find out that what appeared to be diabetes was something else that had similar symptoms. That’s ok and normal. Much like we wouldn’t freak out at our mechanic for finding a different diagnosis, we shouldn’t freak out at our doctor.
The reality is that healthcare must be a collaboration between patient and doctor. Neither should feel so arrogant that they don’t listen to or disrespect the other. Patients should present the doctor with their symptoms, experiences, and findings so that the doctor has as much information about your health needs as possible. Doctors should be excited to have a patient that’s deeply interested in their health. Together they can work through the findings to help everyone understand the best path forward and why something the patient found might not be accurate or appropriate for them.
The very best doctors I know love this type of collaboration with their patients. They also hate when patients arrive in a disrespectful and arrogant way. We need to purge the later from the system so that they don’t ruin it for the rest of us and the doctors.