If people don’t listen to their doctors, who do they listen to?

January 6, 2008 at 5:19 pm 3 comments

A WSJ Online/Harris Interactive Health-Care Poll found that a majority of U.S. adults believe that medical providers over-treat or under-treat their medical conditions. While sometimes this leads to getting a second opinion, other times it leads to not filling a prescription or getting a diagnostic test. The Kaiser Women’s Health Survey found that 22% of women “expressed concerns about the quality of care they got from their physicians or health care providers, compared to 17% of men. This issue was a particular problem for women in fair or poor health (40%).” The nurse practitioner in my doctor’s office once told me that more people take the advice of a stranger in the supermarket check-out line than her advice. There are many efforts to increase the number of people with health insurance, but the availability of affordable professional expertise does not necessarily mean that advice is taken.

I gave a keynote address on Online Communities: Innovative Notions of Expertise and Peer Learning, and started my talk by asking if I should use Weight Watchers or Atkins to lose 10 pounds. Saul Carliner, who was prepared to be a plant in the audience if no one else answered immediately, gave a compelling argument for the long term benefits of Weight Watchers. I then asked who agreed with him, and almost everyone did. One of the few people who hadn’t raised her hand said that diet and exercise need to be tightly coupled, but we agreed that she was only enhancing Saul’s response. I pointed out that we had (1) an opinion from one (somewhat anonymous) person and (2) the wisdom of crowds agreeing with him. I then asked how Saul’s advice would be looked at if (3) we knew that he had successfully lost and kept off weight or (4) we knew that he had a professional experience as a nutritionist. I went on to give a corresponding example on Amazon.com of how book reviews can fit into these categories. However, making a book selection has little cost, while health choices can have enormous consequences.

In What Doctors Don’t Know (Almost Everything), Kevin Paterson writes, “From the first day in the cadaver room and on, every medical student is drilled with this truism: ‘Medicine is both an art and a science.'” He goes on to write that “intuition is certainly an indispensable part of medicine. The body is so complex, and the ways it might go wrong so varied, that in the middle of the night, standing next to some fresh catastrophe, a doctor sometimes needs to generalize and to reduce very complicated problems to first principles. It is simply not possible to be rigorously intellectual and consult the available medical data about every single thing, all the time.”

Even if doctors don’t know everything, they know a lot. But if people don’t listen to their doctors, who do they listen to and are they receiving sound advice?


Entry filed under: health, Web 2.0. Tags: , , , , , , , , .

Web 2.0 and Web x.0 Dear Joe Namath

3 Comments Add your own

  • 1. Diane  |  April 6, 2008 at 10:09 pm

    Lisa, This is all so true and why on-line health communities can be of tremendous support to patients who are searching for information. Diane

  • 2. internettime  |  January 22, 2008 at 8:03 am

    Lisa, I’m reminded of the story Sir Ken Robinson tells about the guy who is sent to a kidney specialist because of pain. “Do you drink?” asks the doctor. The patient says yes, he drinks seven pints of ale every night.

    The doctor advises him to switch to whisky. “Won’t that screw up my liver?” asks the patient. The doctor replies, “Look, I’m a kidney specialist, not a liver specialist.”

    I’ve talked with many physicians. Their goal is to cure illness. Then you’re on your own. (Wellness is not insured,) My goal is to enjoy a high-quality life.

    I’ll keep you posted.


  • 3. Lisa Neal  |  January 21, 2008 at 7:07 pm

    Jay Cross said “My hobby this season is researching and writing a book on how to eat. With contradictory nutrition findings coming out continually, I’m confused about what I’m supposed to eat and what to avoid…” He went on to discuss diet books and farmer’s markets at http://internettime.com/2008/01/17/youre-not-eating-right/. I asked Jay if he had considered a discussion with his doctor about this, and, if so, how did this influence his personal research agenda, and, if not, why not?


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Lisa Gualtieri, PhD, ScM

Lisa GualtieriLisa Gualtieri is Assistant Professor at Tufts University School of Medicine in the Department of Public Health and Community Medicine. She is Director of the Certificate Program in Digital Health Communication. Lisa teaches Designing Health Campaigns using Social Media, Social Media and Health, Mobile Health Design, and Digital Strategies for Health Communication. Contact Lisa: lisa.gualtieri@tufts.edu


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