Are Patients Stupid?

Yesterday I read a USA Today article that was posted on Twitter by Carolyn Thomas at Heart Sisters.  The article is called called Don’t Yelp Your Doctor and it is written by Niam Yaraghi who hails from the Brookings Institution’s Center for Technology Innovation.  The Brookings Institution lists Mr. Yaraghi as “a fellow in the Brookings Institution’s Center for Technology Innovation. He is an expert on economics of healthcare information technology with a focus on Health Information Exchange (HIE) systems. Niam’s research examines the network externalities in the healthcare market and their effects on HIE adoption and usage. His research is currently focused on analyzing the outcomes of HIE use in reducing the costs and increasing the quality of healthcare services.”

I was completely enraged when I read his article in USA Today. The basis of his article is that patients should not rate physicians on Yelp or any other online customer review site. He states “Patients are neither qualified nor capable of evaluating the quality of the medical services that they receive. How can a patient, with no medical expertise, know that the treatment option that he received was the best available one?”.  He continues with “Since patients do not have the medical expertise to judge the quality of physicians’ decisions in the short run and are neither capable of evaluating the outcomes of such decisions in the long run, their feedback would be limited to their immediate interaction with medical providers and their staff members.”

For the record I never give online reviews whether it is for medical care, electronics or strawberries. I only read the online reviews on electronics and usually CNET is my source.  I don’t really believe in online reviews and I certainly would not pick a doctor based on an online review. The proper place to check out a doctor is your state medical board.  There you can find negative information on doctors.  As an example for Kansas, you would go to http://www.ksbha.org/main.shtml to research complaints against a doctor.

My objection to his article has nothing to do with online reviews and has everything to do with the implication that all patients are ignorant when it comes to their own medical conditions and completely incompetent to make medical decisions. This is a ridiculous implication. This implication suggests that one should never question the care they receive or the decision of their doctor because they don’t have the appropriate education.  Bullshit.  I can give him excellent reasons you should absolutely question doctors and that you should not go back to a physician you don’t like and wouldn’t “rate” highly.

First and foremost is my visit with a new family physician after my long time doctor left his practice to take a research position.  This was my first time with the doctor that took his place.  He was prescribing me an antibiotic and I am allergic to penicillin so he told me he would prescribe Zithromax.  Good choice if every cardiac provider that I have seen had not warned me about taking this antibiotic.  When I brought this up to him he got very arrogant and seemed to chastise me for challenging him by saying that cardiologists overreact to this antibiotic and that not every person who has taken Zithromax has died.  When I asked him if he knew I was a heart attack survivor he treated that like it was no big deal and he had no interest in discussing that.  When I told him there was no way I was taking it, we settled on doxycyline.  Why on earth would I give him a good review after this encounter?  If there were an online medical review site that listed asshole, I would go fill it out. I absolutely will not see him again.

Perhaps we should take a look at an earlier blog post of mine, Gender Inequities In Cardiac Care – You Must Advocate For Yourself.  In this post, I discuss an email I received from a woman in Georgia who was not referred to cardiac rehab post cardiac event. How is it that this woman did not know about cardiac rehab?  When all of the studies show that it is of great benefit, some doctor made a decision not to tell his patient.  If I knew what doctor that was, I would tell everyone I know not to see him. In my opinion, this is inadequate care.  I challenge Mr. Yaraghi to argue with me on this when numerous studies support my stance.  How is that for not having the knowledge?  A patient who reads medical studies on her condition?  Apparently unheard of in Mr. Yaraghi’s world.

The fact is that there are a lot of very qualified and excellent doctors and I have the highest respect for them.  Just like any other profession such as financial advisors (the example Mr. Yaraghi uses), some are excellent and some suck at their jobs.  Patients should not be chastised into thinking that because they do not posses an MD, they do not have the common sense to be able to weed out the providers that are not providing good medical care. For a national news publication to allow an article that suggests this is irresponsible.

4 thoughts on “Are Patients Stupid?

  1. You tell ’em, Jodi. Your experience with your new physician is a perfect example of what we’re talking about – although one that our friend Yaraghi might just snort at…

    I’m also glad you brought up the Georgia example of failure to refer to cardiac rehabilitation, a therapy that as you mention has been widely proven to significantly reduce mortality and improve outcomes for heart patients. We know this is considered a Class 1 Recommendation by every cardiac society worldwide for this reason.

    We know this because we are not stupid.

    We also know that physician endorsement is the main predictor of patient attendance/completion of cardiac rehab.

    We know this because we are not stupid.

    Yet we also know that doctor referrals to rehab are as low as 20%. TWENTY PER CENT! As Oregon cardiologist Dr. James Beckerman says bluntly about such pervasive failure among his colleagues: “It is bad medicine to withhold livesaving treatment from patients.”

    You are 100% correct to argue with your (former) doctor about Zithromax in an attempt to inform him. You knew this because you are not stupid.

    Apparently, our friend Yaraghi wrote what he wrote because he has met only stupid patients. Pity he hasn’t yet encountered anybody like you…

    Kind regards always,

    C.

    Like

    1. Thanks Carolyn!

      Perhaps he needs to really research what chronically ill patients know about their illnesses before he assumes. If he did, he would realize there is a large army of patients who want to know what their doctor knows and they read a lot of what their doctors read.

      I did read the follow up you posted about the conversation that Casey had with him. Open dialog is a good thing. Perhaps he can explain the ignorance! ( http://mightycasey.com/yelp-this-b-tch/ to read the post and https://plus.google.com/u/0/events/co95pcvfi9jc2ltv2cacdpgqjvo to attend the live talk). It should be interesting!

      Best,

      Jodi:)

      Like

  2. Hello 🙂

    I have cross posted both your article, and excerpts from the original article.
    I recently survived a SCAD (dissection at LAD) heart attack. This particular “Unicorn” is often misdiagnosed, and has a high mortality rate.

    I, have a post graduate degree.
    I know how to research.
    I can add, subtract, multiply and divide.
    I can read the same scholarly jounrals that all doctors can, as I went to college and have a liftetime pass to the same Databases that the Mayo uses, or UCLA, or whatever university that uses scholarly journals (ALL).

    I had my SCAD on a Monday. I don’t have heart disease in any way.
    I don’t have high numbers, Trigs are normal HDL and LDL are appropriate, I had a heart CATH, and my vascularture is pristine. I spent the night pulling some 600 articles down from the cloud, reviewing them and preparing to discuss SCAD with the doctor in the morning. I was concerned he would stent me, which has a high arrest rate and is NOT something you do to a SCAD patient with falling Triponin levels. He concurred. I can have this conversation not only because I’m not stupid, but I’m actually informed. If my doctor doesn’t see my care as a team effort, good riddance.
    I have enough trouble being taken seriously because I’m a woman, I don’t need the further complications of bad bedside and God complex.

    Guess what? I AM THE SUBJECT MATTER EXPERT. I am always going to be the subject matter expert on myself, and that’s why we have to grow spines and stand up for ourselves. Advocate hard for yourself!

    My doctor has seen 1 other SCAD patient in his entire career. His practice has had 5 total in 30 years. I have read more research than he has. He admitted that. His practice sat with me and took notes from me. This is appropriate. Any other reaction would have been less than appropriate, and would have sent me into a stress spiral. It’s more than just bad bedside manner. We aren’t livestock. You do have a voice, and you should use it wisely.

    Thanks for the article.

    Like

    1. Hi Noelle!

      Thanks for sharing! I am so glad you stopped in here!

      Congratulations on beating something that is so very deadly! You hit the nail on the head with it being a care team. When I take something to my doctor to discuss that I have seen/heard/read, I want them to be open to that and not to condescend me. I am on my 4th cardiologist and she welcomes this. One reason is probably because she has been on the national medical review board for WomenHeart. She is fabulous! It is so important to have this kind of care.

      Articles like his make it seem as though this kind of care can’t exist. How discouraging to someone that has just become chronically ill!

      Do you have a blog or are you on Twitter? I’d love to follow your story!

      Best,

      Jodi:)

      Like

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