There is a lot of debate in the medical world about how involved patients should be -- who should have "control" over care. For example, we know that patients who have a clear understanding of their conditions and ask questions when needed have better outcomes. Doctors, sometimes rightly, might fear the patient who comes in a handful of printouts from the Internet and requests a specific treatment or approach. They may be concerned that the patient could stand in the way of providing the treatment that is needed. On the other hand, patients often feel that doctors doesn't really know them or understand their situation. Meanwhile, the drug company ads depend on the patient who goes and demands specific treatments.
Patient Control Versus Doctor Control
A small study looked to see which approach -- doctor-driven or patient-driven -- works best for hypertension and high cholesterol management. They asked patients what type of control arrangement they preferred. They found that the patients who preferred more control in decision making did not necessarily have better results. In fact, patients with less proactive attitudes showed the most improvement in lowering their blood pressure and cholesterol.
The Proactive Patient: Sometimes Good, Sometimes Bad
The researchers are careful to explain that hypertension and high cholesterol are specific conditions with no physical symptoms. Patient involvement may be vital in other situations, such as diabetes, where the patient experiences the illness in everyday life. In the end, the researchers conclude that a patient being proactive may not be helpful in all conditions and that the relationship between doctor and patient is complex. They do not rule out the possibility that patients who demand more control are doing so because they feel their doctor is inadequate. It's possible that the best doctors have to trust their patients and their desire for more control over the situation.
Ask questions of your doctor. Do what you can to learn about and understand your condition and treatment. Just remember that are going to a doctor for his or her expert opinion and clinical experience -- something the Internet just can't replace.
Source:
Baldwin AS, et al. Preferences for a patient-centered role orientation: association with patient information seeking behavior and clinical markers of health. Annals of Behavioral Medicine 35(1), 2008.
