About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

8 comments on “In Health Care… Fear Sells

  • Excellent article. As a gyncologist, I also have seen many patients frantic with fear about their asymptomatic ovarian cyst or fibroids. I try to steer my patients to reputable online sources (I usually recommend http://www.uptodate.com, and while their content isn’t flashy, at least I know it is reliable and evidence based ). I agree, though, the most reputable content is that which we ourselves can generate. Thanks for the great post.

  • It’s not just a matter of creating appropriate content. It’s a matter of explaining to the average patient why certain content is more reliable than others, and teaching him how to read between the hype (this includes the biases in peer-reviewed publications as well). It’s also a matter of keeping up-to-date in what’s going on in your specialty (or in multiple specialties, if you are a general practitioner, family physician, or other primary care provider) in general, and what’s going on with regard to the specific concerns of your patients.

    The flip side of fear that I see online is fear of the practitioner. Fear that if you (and I say “you” specifically because I am not a healthcare provider) post something, it might be inappropriately construed by a patient as medical advice directed at him/her, and that you could be held legally liable. Fear that you might post something that cannot be easily retracted when subsequent research and evidence change best practices and standards of care. Fear that something you post might be abridged, reworked, taken out of context, and reprinted elsewhere.

    What many of us in online patient communities would like to see is active engagement by physician-researchers and social/public-medicine researchers who are interested in pursuing our anecdotal evidence about what works (and what does not work) for us as individuals, fill in pertinent missing data, account for confounders, and use “real-life” evidence to inform both best practices and directions for further study.

  • Brenda… you are absolutely correct. Unfortunately there are very few physicians engaging online or even producing content (first stage). When I counsel groups who are interested in venturing online, I put forth the concept of a circle of engagement. The first part is that we need content to even begin a discussion. We need to help patients interpret studies and see through the obvious bias that exists in many research studies. We need to listen to patients, incorporate their values and other shared decision making principles in our practice and become comfortable with the engaged or “e”-patient population. Then I describe a situation where the physician becomes comfortable posting online (with proper disclaimers in place) — and if they want to *learn* to interact with others and engage online we start with twitter. Simple, easy to lurk and become comfortable. Then we discuss blogging with an open comment stream and finally we reach a stage where the doc is interested in closing the loop, so to say…. where they are ready to openly engage online on various SM platforms, produce content on a platform that allows for comments or feedback… etc.

  • It might also be worth directing patients to http://www.tripdatabase.com
    They have a great set of non-commercial patient information leaflets, and other content such as guidelines which are really useful.
    Hope you find it as helpful as I do. If you have suggestions for content I’m sure @jrbtrip would be delighted to hear from you.

    • Thank you… as always I appreciate your advice. Once I figure out where I have my outside links on my new WordPress site I will post your link. It looks very interesting… need to explore the Tilt section! Thx again.

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