Thursday, November 22, 2007

Information Asymmetry reversed

A Doctor’s Disdain for Medical ‘Googlers’;
Can a patient ever show up at the doctor’s office with too much information?

A doctor’s essay about medical “Googlers” — patients who research their symptoms, illness and doctors on the Web before seeking treatment — suggests they can. The report, which appeared in Time magazine, was written by Dr. Scott Haig, an assistant clinical professor of orthopedic surgery at Columbia University College of Physicians and Surgeons. He begins with a description of a patient he calls Susan, who seems to be clicking on a keyboard as she speaks to him on the phone. “I knew she was Googling me,'’ he writes.

Dr. Haig’s disdain for her information-seeking ways becomes quickly evident. He describes the woman’s child, whom she brings to the office, as “a little monster'’ and notes that the woman soon “launched into me with a barrage of excruciatingly well-informed questions.'’ Every doctor knows patients like this, he writes, calling them “brainsuckers.'’

1 comment:

Julia Schopick said...

I am a huge proponent of Googling, since many times during my husband’s 15 years as a brain tumor survivor, my online research literally saved his life.

While I was not surprised to read that Dr. Haig (not unlike many other doctors, unfortunately) is so opposed to patients who Google, I was extremely offended by his disrespectful attitude toward this particular patient.

Dr. Haig was offended that “Susan” Googled to find information about her condition. But I think he was particularly offended that she also found personal information out about him.

Ironically, one thing that stands out for me is that “Susan” just might not have done ENOUGH Googling about Dr. Haig! If she had Googled a bit more, she would have found some information about him that would have steered her far away from his doorstep.

For instance, in this article, Dr. Haig says:

“Susan had neither the trust of a nurse nor the teachability of an engineer. She would ignore no theory of any culture or any quack, regarding her very common brand of knee pain. . . . I marveled, sitting there silenced by her diatribe. . . .”

Dr. Haig’s use of the word “quack” led me to check to see what, exactly, he thinks qualifies as “quackery.” So, I Googled him — simply using the search terms “Scott Haig” and “quack” -- and easily found another “Time Magazine” article, “Doctors Without Dollars,” at
/article/0,9171,1584803,00.html. Here, Dr. Haig attacks “alternative medicine” in general, including — and I quote —“chiropractors, osteopathic manipulators, prolotherapists, postural therapists, acupuncturists, even Therapeutic Touch practitioners,” claiming that many of his colleagues have started to practice in these (to him, highly questionable) areas in order to make money.

Dr. Haig must really consider himself quite an expert on Alternative Medicine, to categorically insult so many kinds of practitioners in one sentence. And he doesn’t stop there:

“Each of these therapies proclaims the existence of force fields, bodily reactions, energies or auras that simply cannot be measured or observed scientifically. The ‘patients’ who pay these docs run the gamut from the hopelessly deceived to the downright self-indulgent. But lest we look down too haughtily on NRWAT [a term Dr. Haig himself has coined to mean ‘nothing-really-works-anyway therapies’] providers from the moral high ground of real medicine, we must admit that their patients come back again and again, seemingly happy with the treatments. And they pay them with real money — which seems, alas, to have become the whole idea.”

Then, if Susan had gone through more of Dr. Haig’s articles on the site, she would have come across another one that might have clinched the fact that he and she weren’t on the same wavelength: his August 11, 2006 column, “Before You Pop That Pill” at
article/0,8599,1225657,00.html . Here, Dr. Haig points out that he spends “lots of time straightening out people’s thinking about medicines.”

One of the ways he “straightens out” his patients’ thinking is to warn them away from taking glucosamine-chondroitin pills for arthritis. He says patients ask him about these pills almost every day.

Here’s what he says:

“They’re not cheap but they are not dangerous and, according to a well-done, recent study with 18,000people — (half gets the stuff, the other the placebo and neither knows what they got until they report how the pills worked) — they are not effective. They are ‘natural’ though, and many patients love them. The say their pain is ‘relieved’ and they are sure the stuff works because of something about never having seen a shark with low back pain. Educated, rational people — even my favorite rheumatologist — still swallow the stuff. Go figure.”

At this point, I am almost embarrassed FOR Dr. Haig. First, he doesn’t cite this particular study, so that his readers can check it out for themselves. Second, doesn’t he know that many of the “studies” done on natural treatments are carried out with the express purpose of proving that these treatments DON’T work? Often these “studies” are performed for pharmaceutical companies by doctors who, like the companies themselves, have a vested interest in “proving” that non-pharmaceutical treatments don’t work!

“Bottom Line Secrets” recently carried an article that discusses this very serious problem: “Why You Can’t Believe Anti-Antioxidant Findings,” at
blpnet/article.html?article_id=43337. But it is the article’s subtitle — “It’s Not News When Flawed Study Yields Flawed Results” — that tells the real story. Here, Dr. Mark Stengler is quoted on the topic of “slanted research,” in which “researchers set up the study so it would confirm what they already believed, which was that supplements are a lot of hooey.”

It’s an interesting article, which I first read about on patient advocate Trisha Torrey’s excellent blog. (You may read her posting, “Medical Research Studies Take a Hit,” at h-studies-take-a-hit/ )
These two articles articulately and compellingly point out WHY we can’t always believe “studies,” simply because they’ve been published.

You might also want to listen to a very interesting interview on this topic that I did with noted integrative physician and author, Ronald Hoffman, MD, for my blog, (The interview may be downloaded at tml .) Here, Dr. Hoffman talked with me at length about several such “studies,” in which the “researchers” had agendas that were clearly antithetical to natural medicine. Among the studies he discussed with me is a famous 1979 Vitamin C trial at the Mayo Clinic, conducted by Dr. Charles Moertel, adversary of Vitamin C proponent Linus Pauling. In this “study,” extremely sick colon cancer patients, who had already failed to respond to chemotherapy, radiation and surgery, were given VERY SMALL DOSES OF ORAL VITAMIN C. (Of course, it is INTRAVENOUS Vitamin C that Dr. Pauling claimed worked.)

In this interview, Dr. Hoffman gives other examples, too — for instance, a faulty St. John’s Wort “study” that was performed by (you guessed it!) a pharmaceutical company that produces a well-known antidepressant!

So, if “Susan” had done her Googling a bit more effectively, she would most surely have found out more about Dr. Haig’s prejudices, and might not have gone to him in the first place.

Julia Schopick