The Democratization of Medical Knowledge

April 16, 2008 at 12:08 am 6 comments

Marcus Welby, MD is an anachronism. The family doctor who pays house calls no longer exists except for some anachronists or doctors working in a few specific situations. The show, which ran from 1969-1976, predates the web. Hence Marcus Welby and his assistant probably got most of their medical updates from their monthly JAMA.

The amount of medical knowledge that exists and the amount that medical professionals need to know is constantly growing. Medical literature doubles every 19 years and, for AIDs, every 22 months, according to Tonya Hongsermeier, MD.

How can anyone possibly stay current? This is especially important because of the criticality of the information, not just the amount. As Tonya points out, doctors can be aided by tools that assist them, for example, alerting them to possible negative interactions between medications and other medical risks. Initiatives to codify knowledge and increase patient safety are taking place at Partners Healthcare.

Patients, who had limited access to medical knowledge in Marcus Welby’s days, now have a wealth of information available online – in fact, can access most of what physicians read. However, patients generally lack the basic knowledge and frameworks to understand and make sense of this abundance of readily accessible knowledge and, even more importantly, how to apply it. This is primarily due to lack of medical training and poor health literacy.

This democratization of medical knowledge, according to Larry Prusak, is a double-edged sword. Doctors struggle to stay on top of advances and, at the same time, patients increasingly try to acquire medical knowledge about their own or their loved one’s health. The disconnect between patients and doctors can be attributed in part to this democratization, which has changed the relationships between patients and their providers. The notion of empowered patients is one few could argue with; however an important component of expertise is knowing what you don’t know, knowing what to ignore, and knowing what is important. “There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore,” but many patients, understandably, lack that expertise as well as the necessary detachment. In fact, even doctors don’t treat themselves.

Not to digress, but I wrote about health and media recently and was interested that Marcus Welby, MD had an episode that focused on the diagnoses of breast cancer in two women, aired when “the wives of two public political figures” had been diagnosed with breast cancer. “The most motivational moment of this episode is James Brolin’s emerging from character to talk about diagnostic and early-detection tools for breast cancer. Such is the hallmark of television that [it] is not only entertaining but informative.” (This also goes to show the amazing information you can find on the internet when you aren’t even looking for it.)

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

Crucibles as a Metaphor for Learning and Reflection The Democratization of Health Knowledge by Steve Denning, Guest Contributor

6 Comments Add your own

  • 1. ole  |  March 13, 2009 at 9:47 pm

    nice topic, i like your posting very much,may we can share each other, what a nice medical blog

  • 2. Francesca  |  April 17, 2008 at 4:44 pm

    Thaks, Lisa. This is a very interesting post. I am studying now about the utility of the Communities of Practice in the public Health Care System, and I am sure that they are the principal context in which we can work out the excess of information through mutual engagement.

  • 3. Mike Gualtieri  |  April 17, 2008 at 7:16 am

    Great post Lisa. I am doing some research on the Future of Application Development and see a parallel between patients being empowered with medical information and businesspeople being empowered with technical information. “A little knowledge is a dangerous thing” is heard throughout the software development cube farms. Yuck! Cube farms.

    Marcus Welby was nice. He had a great “bedside manner”. Dr. House on the other hand is practically at war with his patients – mocking them, making life or death jokes and being completely and totally honest with them. He gets away with it because he is absolutely brilliant at solving the unsolvable medical cases that in all cases save the life of the patient. Dr. House is more like a detective in an Agatha Cristie novel than a doctor. What is both impressive and scary at the same time about his diagnosis, is that he justs tries stuff. If it works he keeps doing it if it does he tries something else.

    The point is that medicine is as much art as it is science. I imagine it is like debugging code. You try stuff until you find the bugs.

  • 4. drtombibey  |  April 16, 2008 at 7:14 am

    P.S. I liked Dr. Kiley better.

    Dr. B

  • 5. drtombibey  |  April 16, 2008 at 7:13 am

    Dr. Neal,

    Enjoyed your post, and your points are well taken.

    I am a country doc, and have lived, breathed and read the stuff for 25 years. I still enjoy what I am doing. No one knows all this medical business, but I feel like I am doing more good than harm, and can still ace the young folks on the Boards. (94th percentile last outing and still reading)

    Come check out my blog. As far as I know, it is the world’s first physician bluegrass fiction writer’s weblog. Evn thought it is fiction, it is true. As the good Lit Prof said, “For it to be good fiction, it need not necessarily have happened, but it must be true.”

    Dr. Tom Bibey

  • 6. The Democratization of Medical Knowledge | Medical Alarms  |  April 16, 2008 at 12:25 am

    […] Read the rest of this great post here […]


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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:


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