Google, MD

An article in the New York Times , referring to an earlier article in Time magazine, concerns the attitude of one doctor regarding what he calls 'excruciatingly well informed' patients. He was disconcerted and nonplussed to find that this woman, a prospective patient, had researched her condition, and him.

Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived. It was a little too much — as if she knew how stinky and snorey I was last Sunday morning. Yes, she was simply researching important aspects of her own health care. Yes, who your surgeon is certainly affects what your surgeon does. But I was unnerved by how she brandished her information, too personal and just too rude on our first meeting.

He said that she was, essentially, too well informed; she knew much, but didn't have the ability to discriminate in what she knew. Its not clear if he was challenged by her knowledge, her attitude, or both, but his conclusion was that he didn't want to treat her, and so he sent her on her way, recommending a different doctor.

I couldn’t even get a word in edgewise. So, I cut her off. I punted. I told her there was nothing I could do differently than her last three orthopedists, but I could refer her to another who might be able to help.

The original article, here, makes his case a little better. It makes it a little worse, too.

It's hard to sympathize with this guy; very easy to think that he's simply used to being in the catbird seat when it comes to brandishing power and knowledge in the doctor-patient relationship, and uneasy at the thought of actually having to work at it this time. Doctors may like (or be forced to expect, in a litigious world) well-informed patients, but, the article goes on to suggest, they like them to be submissive, too. Is that true?

Certainly, when you're just getting twelve or fifteen minutes of a new doctor's time, you need to make your case quickly and even authoritatively. As an article I read years ago about a neophyte pediatrician's experience with an experienced child (one who had a chronic life-threatening condition, and had seen many, many doctors) put it, the child looked at her holding a needle uncertainly and said, grimly, "You get one chance." Its possible that this woman was doing the same thing, saying, in effect, I know you and what you do; I know me and what I need; you get one chance at proving to me that you're the doctor for me.

Perhaps she handled it badly. As the original article points out, her condition was treatable, but the treatment was not guaranteed, painless, or immediate. Her attitude suggested that she wanted all of those things, and would not accept anything less. But she was not alone in mishandling the situation. His attitude was condescending and patriarchal. He gave up on her because he didn't like that she -- and to be fair, her terrible young child, who accompanied her -- didn't treat him with the appropriate amount of discretion and respect. She pushed him, and he didn't like it.

Neither came across well... but only one lost.