Patients are the new doctors

I regularly see patients who, rather sheepishly, tell me that they have ‘googled’ their symptoms to try and work out what might be wrong with them. They often add something like ‘I know shouldn’t have”. Finding useful health advice on the internet can be a bit of a lottery, but I personally have no issue with patients googling their symptoms and looking for information. My experience in practice tells me that they will very often find something that is of genuine use to them and their health practitioner (if open-minded enough).

The rise of the internet has seen medical and research information become much more available to individuals. And boy have people seized the opportunity to access this information in an effort to understand better how to overcome illness and enhance health. Not uncommonly I see patients who know far more about some health matter than I. I like to embrace this, personally, as it usually means that person is likely to progress faster down the path to health than if they hadn’t bothered to or been able to educate themselves. And I have generally have no issue at all (quite the reverse, actually) with a patient educating me about some health matter.

Another trend I’ve noticed is just how much people have been able to tap into the collective experiences and wisdom of others. I see this quite commonly in diabetics, for instance. I’ve seen quite a few diabetics who have found controlling their blood sugar levels difficult on the low-fat, high carbohydrate diet often recommended to diabetics (go figure!). Many of these diabetics go looking for or stumble across a forum like this one where individuals can swap stories and idea relating to low-carbohydrate eating.

Some will feel sufficiently convinced to give this type of eating a try and will usually see a significant improvement in their blood sugar control and a reduction in medication requirement as a result. Some will run the idea past their doctor or diabetologist first, but some will not. In effect, those in the latter group have made a self-directed decision about their diet and healthcare based on the experiences and advice of, not healthcare professionals, but ‘ordinary’ individuals with experiences and ideas to share.

I’ve heard many healthcare practitioners express horror that this sort of thing going on. For example, dieticians or dietician bodies very often warn about the supposed perils of taking ‘a whole food group’ (e.g. starchy carbs) out of the diet. The idea here is that somehow such a person is being reckless and risking a diet deficient in key nutrients. In my view, this person is unlikely to be exhibiting any recklessness at all, and there’s nothing found in these starchy carbs that cannot be found more healthily (in my opinion) elsewhere in the diet. And let’s not forget that this particular dietary change is often accompanied by an improvement in not just blood sugar control, but improvements in a range of disease markers.

I was motivated to write about this on reading a recent piece form the deputy editor of the British Medical Journal [1]. Entitled ‘Patient Powered Health’, this piece explores the notion that the internet can be a source of useful information from the lay public that can inform patients and help direct their care in ways that supersede conventional medical care.

The same edition of the journal contains an account from someone – Dave deBronkart – who was diagnosed with advanced kidney cancer, and who’s doctor suggested he take a look at acor.org, an online resource for individuals with various forms of cancer. deBronkart posted a message on the site, and within two hours he: “got facts and practical advice that to this day don’t exist in any journal article or establishment website,” including information about the best treatments and side effects from those who had already experienced them.

The editor’s piece goes on to say: “The internet and online communities are often rightly criticised as sources of misinformation and bad advice. But deBronkart’s story illustrates the contribution that informed and engaged patients can make to the complexities of medicine.” deBronkart is quoted as saying: “The value delivered by skilled clinicians is still there, but now we can see that it’s no longer the only source,” he writes. “Please, let patients help improve healthcare. Let patients help steer our decisions, strategic and practical. Let patients help define what value in medicine is.”

The BMJ has a long-running ‘Patient’s Journey’ series which is partly designed to achieve this end (letting patients help define value and quality in medicine is). The BMJ’s patient editor, Peter Lapsley, adds: “There is no privileged vantage point from which to decide who is right and who is wrong.”

That’s right, I think. We doctors no longer have a monopoly in health information and advice. Patients now have the potential to learn much from the experiences and wisdom of other patients. I don’t think we doctors should be threatened by this: I think we should embrace it, partly because it can benefit patients, and partly because our patient’s experiences and ideas can benefit we doctors too.

References:

1. Jackson T. Patient powered health. BMJ 2013;346:f2255

29 Responses to Patients are the new doctors

  1. Vanessa 23 April 2013 at 9:41 am #

    Hear, hear. In the case of memory problems related to statin use, online forums and readers’ comments, as a source of information, have been invaluable. Relying on information provided by the so-called experts is subjecting thousands of people to serious side-effects that are likely to be misdiagnosed as dementia, and those experts don’t accept the connection. However plenty of people have made the connection themselves and taken themselves off the drugs to good effect having found they’re not alone.

  2. Anna 23 April 2013 at 11:20 am #

    This describes me exactly. I noticed by chance some months after my gestational diabetes was said to have “resolved” that I still had high blood glucose levels. Ever since then I have seen three different doctors, all of whom have failed me. If it weren’t for the collective experience of diabetics who have managed their disease successfully for many years, I would not have figured out the proper strategies for myself (or it would have taken far longer). I am very grateful to the online diabetic communities who advised me far better than any of my doctors, as judged by my success with blood glucose control and overall improved health. It is a shame that the medical community is so slow to change, it is like trying to move a stick through the mud.

  3. Liz 23 April 2013 at 1:28 pm #

    Had I not been my own doc and researched doc google, I would still be suffering from various symptoms.
    I had food poisoning and the trauma from vomiting sent me into afib, I felt it as I vomited about the fourth time. My very first epidode, ever.
    The ER ignored the vomiting as a cause.
    Fast fwd two months later I begin having various symptoms, doc google led me to the vagus nerve.
    I knew this nerve was playing a part in the cause of these symptoms. My doc, two docs, said possibly this could be an issue, but didn’t move forward in finding relief for me.
    I finally found a neuro chiro who listened to me and agreed that it was the vagus nerve!!
    She treated me for about 3 months and I am 97% symptom free.

    I will continue to be my own doc and supplement with the pros as needed. If they are condescending, I will not return to them.

  4. Jeff C 23 April 2013 at 2:12 pm #

    Most doctors don’t like to think of themselves this way, but they are businessmen selling a product (i.e. their medical services). Would someone go into a car dealership and tell the salesman, “I know I shouldn’t have, but I researched the car on the internet before I came down here”. I’m sure the salesman would love nothing more than for customers to solely rely on his advice and the glossy brochures. It doesn’t work that way, prior research makes better informed customers regardless of what is being sold.

    Just like that car salesman, many physicians prefer uniformed patients that mindlessly follow doctors orders as it makes their lives easier. While a little knowledge truly is a dangerous thing, the answer is more informed patients (customers) not ignorant ones.

  5. jake 23 April 2013 at 3:44 pm #

    I believe that the greatest breakthrough in the history of medicine is the internet as it allowed crowd sourcing of health information. People interested in their health could bypass the academic, medical, government and media information gate keepers to make changes that improved their lives.

  6. eddie watts 25 April 2013 at 8:08 am #

    what jake said. also drugs companies don’t have to warn of side effects of their drugs, now i imagine the internet will make these negative side effects more known through the wisdom of crowds effect. (bad pharma by ben goldacre is proving an eye opener for me!)

  7. Martin 26 April 2013 at 3:54 am #

    From a portfolio manager point of view the nutritionists have very non diversified portfolio (single means of livehood) and are consequently very risk averse (unwilling to recommend alternatives to the mainstream). On the other hand patients have no investment and the motivation to take risks and experiment is high as the potential return is high (health). In my view the future is in building knowledgebase within higly specialised communities of patients.

  8. André 26 April 2013 at 2:47 pm #

    I think more and more people see the connection between diet and health. The medical profession isn’t trained in diet, doesn’t think in terms of prevention, and has a financial interest in supplying medicines.

    So I’ll be my own doctor!

  9. Pam 26 April 2013 at 3:05 pm #

    Couldn’t agree more with everything written!
    I had polymyalgia rheumatica, PMR for short, for 3 years, necessitating being on steroids. Most doctors haven’t a clue about this very variable condition, and if it hadn’t been for finding an on line forum where sufferers could swap tips and ideas – and also factual information I would still be on steroids I believe.
    It was, literally, a life line for me.
    Incidentally PMR responds well to low carbs being an inflammatory condition. Oddly most patients seem to crave carbs at first particularly, though whether this is due to the steroids or the condition I don’t know.

  10. Laura M 26 April 2013 at 3:28 pm #

    If only more people knew how incredibly badly thyroid patients like me have been treated by condescending, irrational, rigid and plain ignorant doctors over the years! Millions of us have benefited from informing ourselves via the internet, having suffered real damage from their terrible advice. The internet is the only way most of us can find similar patients to ourselves, find alternative and more successful ways of treating thyroid insufficiency and Hashimoto’s, and get advice on finding GOOD doctors who will prescribe according to symptoms instead of single-mindedly worshpping the TSH test.

    If I hadn’t found Thyroid About.com, and the Stop the Thyroid Madness website, I would never be the happy, healthy person I have been for several years on natural dessicated thyroid (NDT). I’d still be suffering from the symptoms that three doctors described as ‘just the way you are’ – two said I needed antidepressants to help me accept that, if I didn’t feel well on synthetics according to the TSH test, it was because I had an anxiety disorder.

    Instead, with the help and support of experienced thyroid patients I found on the net, I felt better within a mere two days on Armour NDT that my establishment docs had practically equated with evil! I treated myself for a while (sneaking my meds into the UK via internet pharmacies!) way better and more carefully than any of them ever did. I’ve since moved to Canada and with the help of the net found a great doctor who prescribes NDT, orders the right comprehensive tests, pays attention to my symptoms, listens to me and yes, learns from me.

    I’ve since improved my health even more by going paleo and gluten-free. The game is up with the medical system, the diet establishment and especially, anyone hoping desperately that their doc is an expert with all the answers to fix them! Health is now a collaboration – a collaboration towards health between patients, doctors and yes, informed, experienced and generously helpful people on the internet.

  11. Dr John Briffa 26 April 2013 at 3:38 pm #

    Laura M

    You’re a classic example of what good the internet can do in terms of helping people with their health issues. This sums it up for me (thanks for sharing):

    The game is up with the medical system, the diet establishment and especially, anyone hoping desperately that their doc is an expert with all the answers to fix them! Health is now a collaboration – a collaboration towards health between patients, doctors and yes, informed, experienced and generously helpful people on the internet.

  12. Cassiel 26 April 2013 at 3:51 pm #

    I totally agree with this. I suffered from debilitating chronic fatigue (with a whole bunch of other crazy symptoms) about 2 years ago, for almost a year, and doctors either would not listen to me and disbelieve me (“you look fine” and “your test results are fine” were the most common responses) or else would send me off to do a plethora of pointless tests, some of which I had to pay a lot of money for. In the end it was repeated Googling of my symptoms that led me to find out that they were ALL listed as side-effects of the anti-depressant I was taking. But that was only in the American documentation for the medication — I am in Australia, and the Australian documentation (ie the one I actually got given together with the meds) only listed a few of them. I stopped taking the anti-depressant (against doctor advice) and after a week of weird side effects, my fatigue was GONE. Just like that. Because of that illness, I lost a year of my life, lost my job, and had to move home… and then in the end solved the problem myself with Google. And it was all caused by a drug prescribed by a doctor that hadn’t even been doing what it was supposed to do (that is to say, I was still depressed!).

    I’ve also suffered other chronic health problems that I’ve solved more recently through discussions on online forums with other people who suffer the same problems, and thanks to their sleuthing and suggestions, I was able to figure out that I have an awful copper/zinc imbalance and have been treating it with zinc supplements. This has seriously changed my life in the last six months and improved my quality of life incredibly. But doctors kept dismissing my symptoms, and when I initially went to get my copper and zinc levels tested, I had to work hard to talk the GP into approving the tests, because she “couldn’t see the point”.

    Online forums for LC and paleo have also been instrumental in helping me figure out the optimal diet for me and working through symptoms and resolutions of said symptoms; heck, if it weren’t for the internet I would never have found LC/paleo and I would never have cured myself of 20+ years of crippling major depression and anxiety just by cutting out sugar and wheat! (Which I saw countless doctors for.) Why did no doctor ever suggest I change my diet?

    Tom Naughton did a great talk awhile back citing the idea of the wisdom of crowds, and I firmly believe this is the way of the future for patients. Yes, I take everything I read on the internet with a grain of salt (mmm, salt) but if dozens or hundreds of people try the same thing and see the same results, I trust them way more than my doctor who has no experience with said problem and can only report what a drug rep or outdated textbook told him. The only doctors who will keep up and not go the way of the dinosaur (or print media — look at the newspaper industry!) are those who recognize that things are changing and work WITH the change, not against it. (Like you, Dr Briffa! :D)

  13. Megan 26 April 2013 at 4:03 pm #

    I was able – after several years of becoming a “problem patient” – to use the internet to prove that a drug I had been prescribed was not only inappropriate and risky but banned for use except in exceptional circumstances none of which applied to me. It had been prescribed by a nurse working for a pharma company within the surgery. A year ago, rather than listen to me, a GP bellowed at the top of her voice “How dare you say that we do not supervise our nurse prescribers adequately”. No apology has been forthcoming, of course; merely red faces. I’d change my practice but is there really anything better out there?

  14. Gemma 26 April 2013 at 5:08 pm #

    I completely agree with this. Think thyroid and interstitial cystitis.
    My GP appears to be aged about 12 and can only think in terms of PPIs.

  15. Helen 26 April 2013 at 5:20 pm #

    Agree with everything here, especially Laura re treatment of underactive thyroid. I suffered for 25+ years on synthetic T4, then found, via the internet, two recently established UK patient groups who have offered me so much well-informed advice when I was too ill and too foggy to work out for myself exactly what to do. They also put me in touch with a non-NHS consultant who absolutely believes that patients should empower themselves by gaining as much knowledge about their conditions as possible. He actually listens to me (and no, he doesn’t charge a fortune).

    However, specialists like mine are really being hounded by the GMC for going against the rigid approach currently endorsed as the only one acceptable by the Royal College of Physicians. This is making life very difficult for patients too. I could write about this at length, but this all about hanging on to power and perceived authority. Most docs cannot handle having to deal with a more equal relationship with their patients.

  16. John Walker 26 April 2013 at 5:34 pm #

    ‘You are obese. You are clearly eating too much.’
    ‘Your cholesterol level is high. You are clearly eating too much fatty food.’
    Despite the fact I knew I wasn’t eating too much, nor was I gorging on bacon and eggs.

    And some Doctors wonder why we are turning away from them. On another forum (Unconnected with health) I was told by a Doctor on the forum that I was making myself look foolish by claiming I had lost weight by switching to eating high protein, higher fat content foods. Virtually being called a liar of course. Until the truth is accepted, obesity will remain problem and drug companies will make a fortune, ‘managing’ rather than curing the attendant illnesses and conditions.

  17. Hilda Glickman 26 April 2013 at 6:48 pm #

    You mentioned the ‘food groups’ that dieticians use but these are just arbitrary groupings. WE did not have grains until 10,000 years ago so why are they see as part of an essential food group?

  18. Jennifer 26 April 2013 at 10:52 pm #

    My experience covers both of Dr Briffa’s topics this week.
    My GP really frightened me when I questioned my list of repeat medications, by stating that if I discontinued any of the drugs prescribed for hypertension, cholesterol or diabetes, then I was likely to suffer either a cardiac event and/or stroke.
    I was sufficiently concerned about the serious risks and side effects associated with my use of the medications, that after taking advice from professionals,( whom I found on the internet), I then made drastic changes to my diet, i.e 180 degree about-turn on what I had previously been told to eat. I am now off all drugs, and have stabilised my conditions. I have lost 24lbs, bringing my BMI down from 26 to 23, lost 7 inches off my waist, so my waist:height ratio has reduced to a very healthy state, reduced triglycerides to 1mmol, and HbA1c to the normal range, along with healthy cholesterol levels. My B/P is normal, as has always been the case. Unfortunately, my white coat hypertension was totally dismissed for 10 years, thus imposing me to take medication I felt unable to refuse until now. The internet has informed me about many things I instinctively felt regarding inappropriate use of statins, anti-hypertensives, and the ridiculous, stupid dietary advice for type 2 diabetics.
    I could not suggest others follow me in disregarding their GP’s prescribed care. However, I have taken matters into my own hands now, and I must say it has been a frightening road to take alone. The out-come has being nothing short of miraculous for me, but I am upset to think that my GP was deaf to my concerns, and more or less forced me to go it alone.

  19. CHERYL 27 April 2013 at 10:30 am #

    I had a similar situation to Cassiel. I was put on three medications to help my Restless Legs Syndrome; two anticonvulsants and a Parkinson’s drug. After six years I collapsed with fatigue and, on seeing a physician when I didn’t improve with rest, an antidepressant drug was added to my regime, supposedly to help me sleep better. I believe that, although he didn’t say so, he thought I had depression. I took myself off the antidepressant as soon as I realised it was making my symptoms worse, although the physician wasn’t happy I did that.

    I lost eighteen months of my life through this and, when I started overbalancing, having blurry vision, inability to walk a straight line, falling backwards suddenly, hypoglycaemia, sinus tachycardia, low blood pressure to the point of losing consciousness, I again checked the medication side effects on the internet. As Cassiel found (and I’m in Australia, too), all of the possible side effects were not listed on the pharmaceutical companies’ sites and I had to delve much further. All of the side effects were listed and, of course, exacerbated by the polypharmacy. Some were life threatening.

    I had, by this time, seen two physicians and three neurologists. Only one mentioned I was polypharmacised. All of the others wanted to add more medications. One physician diagnosed me with dysautonomia and wanted to recruit me for his research into it.

    I researched how to come off the drugs and came off one of them over a period of three weeks and then came off the other two cold turkey. It was probably the worst time of my life but, after six weeks, I felt better than I had for years, was clear headed, no more overbalancing, no more
    tachycardia, BP returned to normal. The body is an amazing, self healing instrument.

    I have not been back to any of the consultants I saw and am perfectly well.

  20. Georgia Ede MD 27 April 2013 at 12:05 pm #

    A thousand times YES. In fact, even doctors sometimes have to be their own doctors:)

    About 6 years ago I came down with a variety of mysterious symptoms that none of my very smart and caring Harvard-affiliated doctors could explain or help me with. Symptoms like chronic pain, fatigue, migraines, and IBS. Did a single one of my super specialists ask me about diet? No. Not even the gastroenterologist asked me what I ate or made any dietary recommendations, despite the fact that I’d made it clear to him that many of my symptoms only occurred after meals.

    I suspected food must be playing some role in my plight, so I started researching my symptoms on line and in books, and began experimenting with dietary changes. Through trial and error, using a detailed food-symptom diary, I eventually cured myself of every symptom without a single medication.

    Did my doctor care? No. Was she the least bit curious to know how I’d done it? No. Could she have learned from my experience and then helped lots of other patients? Yes. Unfortunately too many doctors are uninterested, uneducated, or unbelieving about the connection between food and health. I hope this is slowly changing, but we have a long way to go.

  21. GT 28 April 2013 at 6:09 am #

    Unfortunately, a lot of doctors don’t take kindly to patient knowledge. Use a technical term and, unless you’re very lucky, you’ll at best get the “Been Googling again, have we?” eye-roll or sigh, or get patronised or disparaged as they attempt to hide their own lack of knowledge. I saw a GP about candida after getting a positive diagnosis in a private test and was told that if I took medication I might feel worse for a short while before I felt better. “Herxheimer reaction?” I asked – a side-effect that’s mentioned in pretty much any book you’ll read on candida. His response was “Whaaat?! You’re just confusing yourself now.” when it was pretty obvious he hadn’t heard of it, but rather than look it up (which would have taken seconds online), he decided to cover his lack of knowledge by sneering at me. Then he decided to change the subject to my weight and offered me “diet pills”. I said I’d just like to talk about possible treatments for the candida. He immediately wrote me a prescription and when I asked for more info on that particular medication, he got exasperated once again, and just said “Do you WANT to treat it or not?” Don’t get me wrong, I’m not expecting a GP to have in-depth knowledge of every condition. And if I’ve got it wrong and they can explain why, that’s fine too. It wasn’t the fact that he’d never heard of the term I mentioned that bothered me, but his response to not knowing.

  22. William L. Wilson, M.D. 28 April 2013 at 11:57 am #

    As a practicing physician with over 30 years of experience, I agree that the democratization of medical information has been a good thing. It’s important to remember the “gold standard” of medical research—the double-blinded study, has severe limitations. Typically it can only look at one variable at a time and biology is a mixture of endless variables acting together.

    That’s where empiric science and evolutionary biology come into play. Empiric science involves making observations in the real world. If you keep trying A and end up with B (the result you are looking for), then it’s likely you are onto something.

    Evolutionary biology involves relying on the wisdom of evolution and Mother Nature. A Paleo style diet was developed using this approach. It’s based on the concept that our genes haven’t changed much over thousands of years so perhaps we should try eating like our hunter-gathered ancestors.

    Nutritionists and many in the medical profession who tend to have a reductionist view of nutrition are often horrified by this approach. As a practicing physician, I tend to stick with the approach that gives me optimal results.

  23. Monika 30 April 2013 at 1:10 pm #

    What an enlightened view Dr. Briffa, and how refreshing to hear it. I also agree with Georgia Ede. As health professionals we need to understand as much as we can, esp. with regard to food / health/disease. There’s a lot to know and we may have missed something. We need to accept we can’t (and usually don’t) know it all. But we can listen, and keep learning.
    I don’t see reductionism as the bogeyman. It’s vital. It just needs to be related back to the whole. Good doctors, nutritionists, dietitians, pharmacists, etc can do this. Mediocre ones probably won’t. Healthcare professionals (i.e. people with a genuine interest in helping others improve their health), like every other profession, have good and bad representatives so let’s not pick on particular disciplines. Empowering people to take responsibility for their own health is a win-win situation for all who care about health.

  24. emily 4 May 2013 at 6:01 am #

    god, how i wish you were my endocrinologist!

  25. Anna Betz 5 May 2013 at 12:48 pm #

    Great reading. Made my heart sing!

    I know about NESTA’s People Powered Health. One of our members who also works for College of Medicine’s innovation network was at their last Health Summit in April. http://www.collegeofmedicine.org.uk/

    NESTA also recently published a paper called ‘Doctor Know’ which I think is a totally unfitting title for a Health Knowledge Commons but nevertheless the idea and concept are great.
    http://www.nesta.org.uk/publications/assets/features/doctor_know_a_knowledge_commons_in_health. We have met with one of the researchers a couple of times.

    Would you like to join or contribute to our group? We are planning to meet on Saturday 11th May in London.
    Our endeavour would benefit from your support.
    In case you are interested we have lots more resources and ideas to share.

    For a future in health powered by all of us for all of us

    Anna

    PS I wrote an article about health commons here: http://commonsrising.ning.com/profiles/blogs/holistic-health-journal-december-2012-people-powered-health-1

  26. Mellie 9 May 2013 at 4:21 pm #

    The main issue, I believe, is to whom does my body belong? And who is responsible for its maintenance? It can only be myself. No one else can be either as knowledgable about my symptoms or as committed to my personal health as I can….information is the real variable.

    Information was withheld for many years while Medical Doctors established a stranglehold on health issues in the last century. “Medicine” was only one among many approaches to health and wellness, concentrating on drug therapy rather than prevention or diet or a horde of other options….but the Medical group (their very name indicates their fixation on medicine rather than wellness) got the upper hand by getting politicians to let THEM set the requirements for the accreditation of health practitioners. Unsurprisingly, only schools that taught the Medical approach were accredited, which is why we have only Medical Schools instead of a smorgasbord of healthful options to achieve and maintain wellness.

    Decades followed in which we were told that health required the expertise of a professional–who would prescribe drugs for our every ailment. Intimidated, we surrendered our control over our own bodies and became passive subjects for medical doctors to practice on. But no more.

    The Internet has put information (often too much of it) back into our hands, and more and more people are realizing the difference between medicine and health or wellness. Prevention (common sense) is making a comeback, and other approaches to health are finally getting some traction. Of course, this represents a HUGE loss of power for the medical establishment, so I expect lots of resistance, legally, in litigation, even brute force. There are unbelievably large sums of money at stake….and very little concern for individuals at the power levels of established Medicine.

    No doubt, it is also galling for good medical doctors who really care about their patients to realize that the VERY expensive education they received in good faith left out so very much critical information because it didn’t fit the medical narrative. I feel for them, but that doesn’t change the fact that they’re interested in treating disease while I’m interested in staying well….a completely different thing!

  27. Bob 13 October 2013 at 10:20 pm #

    I respect your humility as a professional. Not many doctors (from my experience) feel this way about the subject!

    I think what is going is an extension of what is discussed in the economics book–Freakonomics. Essentially the idea of an expert is being eroded as consumers become critical. Health is unique–in that it arguably matters more than most professions. It’s vitally important, at least to people–compared to say saving a few thousand on their homes.

    Most people want their leg to work right! I’ve been self-educating for a year now since I had injury that has been slow to heal, and had some other issues pop up. It’s been sort of a quest to understand what’s going on. Even given Google Scholar, I would argue, professionals are becoming aware of obscure papers, that they simply would not have encountered before. And it happens in such a straightforward–look at this e-mail “click here”.

    Just look at Wikipedia, it’s amazing how perfectly information is described these days. Yes, it is loose and incomplete but there are things that are explained thoroughly that have to do with the present state of “Articular Cartilage Repair” to “Sports Mascots”. The information is endless.

    I think this benefits everyone. The tough thing for professionals (i.e. doctors) is probably limited time to study these paper. Plus things change fast. Old methods become obsolete–but what if they know those methods very well?

    Also the government has a big role in this, in allowing new methods to come through, for example they have been blocking stem cells for years based on ethical arguments. All the patches in stem cell “software” are not worked out but no one would say they aren’t promising.

    Hopefully doctors are motivated to advance treatment as fast as patients will demand it.

  28. Bob 13 October 2013 at 10:37 pm #

    Sorry for double-posting. But yes, If I always took what doctors said at face value
    1) my right foot would be totally healed and I only need heavy PT
    –It’s a non-union fracture and I’m getting a second opinion
    2) There is nothing wrong with my knees even though there noticeably swollen
    –chronic bursitis/scar tissue/ plica syndrome
    3) There is nothing wrong with my hip, it’s in my “head”
    –It’s bilteral FAI. Hopefully it will go away/relieve with proper stretching/Yoga after my foot and knees heal up.

    I have searched basically every method to get back to near-100%. It’s very important to me. Me realizing my dreams, such a banned word in medical circles! It helps the surgeon to have a motivated patient, but I am so motivated, that I won’t accept sub-par answers or conclusions based on what’s going down. I got some weird stuff going on and it’s not necessarily straightforward, but it’s so funny how easily offended they get.

    I saw my doc regarding my foot. He initially told me “I have a non-union and I may have to live with it”, after an x-ray he said “it looks like it’s healing”. At the follow-up (4 weeks, walking boot). He felt my *ankle* and said this seems fine! hahahahahahahah. My *ankle*.

    I asked about the fracture on the bottom of my foot and how the fracture might be unstable (it’s a simple fracture of the 5th metatarsal; I’m 25 YO male with no systematic disease). It should heal if stable.

    He says the “shell wasn’t cracked”. ahahhhahahahahahaahah. If the shell wasn’t cracked, nothing would have showed up on the x-ray! He would have said –you’re FINE! Get out of here kid! Hahahahaha.

    Sorry for the somewhat disillusion-like post but hey it’s true. Hopefully I’ll be healed up soon. I’m committed to it, so long as I don’t give up, I’ll be just fine.

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