More patients turning to the net
MORE people are going to their doctors armed with massive stacks of paper.
They contain information the patient has printed from the Internet on what he thinks he is suffering from.
So when the doctors tell them otherwise, the patients not only refuse to believe them but also begin to argue with them.
Often, many of the patients are wrong.
Patients looking to the Internet for medical information is a growing trend here, say 10 doctors who spoke to The New Paper.
Dr M Wong, 41, a general practitioner, reckons that, based on feedback from private and government doctors in the last three to four years, there has been a 10-to-15 per cent increase in the number of patients who have read up on the disease on the Net before they see a doctor in a polyclinic. In private practice the figure is even higher: 25 to 30 per cent.
This is inevitable, said Dr Tan Sze Wee, Singapore Medical Association's spokesman and treasurer.
GOOD BUT RISKY
He said: 'This is part of self-empowerment and knowledge for the patient, and it's a good way for him to know if the care-provider is doing a good job.'
But it's risky, too.
He said this can be disruptive to doctors, especially when the patients do not understand what they have read or have looked up wrong information.
One way to prevent this is for doctors and patients to work closely together.
Dr Tan added: 'Doctors should keep themselves updated, in the mainstream, and know what it is that patients are interested in nowadays.'
One example, he said, was weight loss. Patients would go on the Net and look it up and Dr Tan said doctors should be familiar with the information available.
When patients come up with their own wrong diagnosis, doctors should tell them where to go on the Net to look for the right information.
Dr Wong recalled: 'One patient even diagnosed himself from Net information! And he was wrong.'
He added that websites such as Medscape or WebMD were very good and the public should also note if such sites are funded by grants from the medical industry as this is a good indication of their reliability.
Some patients go to the Net after consulting their doctor, which most doctors agreed is a good practice.
Dr Wendy Low, 40, a general practitioner, has had several patients coming in armed with pages printed off the Net asking her to explain the text.
She said: 'It's good for doctors if the patients need more information and they go and check up specifically what they need to know after consultation. During consultation, it's not possible for the doctor to tell the patient everything in the limited time.'
All the doctors agreed the old patient/doctor relationship where the patient did everything the doctor asked is gone.
Today patients want to know about everything that has to do with their condition.
Dr Wong said: 'You can help to educate the patient by showing him what to read and where to find the relevant information. Along the way you will get a much better informed patient.'
But there is another danger - waste of precious time.
Doctors are faced with having to sift through a morass of information, much of which is wrong, outdated or unrelated to the patient's condition, said emeritus consultant Professor Feng Pao Hsii.
Prof Feng Pao Hsii
THE NEW PATIENT
That's why he wants to create the New Patient.
After over 40 years working as a rheumatologist, seeing patients with fong sap or arthritis, the man who founded Singapore's first and oldest rheumatology department at Tan Tock Seng Hospital has found a new calling.
He wants to create a 'health-literate' patient who can take charge of his own disease and be a partner to the doctor.
Patients, once grateful, are now more demanding, often non-compliant and occasionally confrontational.
'Some don't listen to you and doctor-hop. They look up information on the Net and challenge you. For this group of patients, the trust between doctor and patient is gone, so it's very difficult to manage,' he said.
When he first entered the profession, people looked up to doctors. He said: 'People did what they were told even when they did not know what they were taking.'
These days, however, medicine has become big business, with cost considerations and customers bent on getting their dollar's worth.
To help them, he has kicked off his New Patient project by holding his first series of 10 three-hour public lectures at the NUS Extension at Park Mall from January to June this year.
He wants to 'demystify medicine' and help patients ask the right questions and gain the right medical knowledge.
His lectures also give pointers on where to go on the Net for information.
'The Internet is like the wild, wild West. It is unregulated and you can find all sorts of information there. And many of the sites exist to push certain products. The trick is to know where to go to find reliable information,' he said.
His next project is to start a website where anyone can access his lectures. He is busy looking for a sponsor as he said it will cost about $15,000 to start it.
Log on to www.patientempower.org.sg to read some of his lectures.
Surfing the right channels
SHE used to type in a keyword on the search engine when she was looking up information on her medical condition.
Then, said Ms Agatha Lau, she would laboriously surf as many websites as she could, one by one.
But she never knew if what she was reading was correct.
Often the language was not easy to understand.
So she never challenged her doctor.
But she wanted to know more.
So she jumped at the chance to attend one of Prof Feng's talks.
Ms Lau, 36, a customer services officer, said: 'I have kidney problems so I chose the module on kidney disease.'
It was better than getting information from the Net, she added.
For that particular module, Prof Feng spoke on functions of the kidney, kidney stones, urinary tract infections and various types of kidney diseases.
'Before, I had a very hazy idea about kidney diseases. Now I have a detailed understanding. Prof Feng mentioned things like high blood pressure affecting the kidneys. I didn't know before it could affect the kidneys.
'The best part about attending the lecture was that I could relate it to myself,' she said.
During the lecture, Prof Feng highlighted a few useful websites such as Merck.com, WebMD.com and Medscape.com
Ms Lau said: 'It gives me a better compass to navigate the Net and I can cut down on the time spent surfing. But when I have nothing to do, I will still surf the Net. I know that ultimately, I still need the doctor as what I read may not apply to me.'
SOurec: NP
