Private practice with Dr Seth Bilazarian

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Internet resources that lead patients down the wrong path

Sep 8, 2010 15:50 EDT


The objective of empowering patients with information that is pertinent to their condition is laudable, but in many cases patients become seriously misinformed by online resources, and much of an office visit can be spent trying to counter dangerously inappropriate information. Is this a trend that we can buck? Do you have a favorite online resource to which you refer your patients?



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Your comments
Internet resources that lead patients down the wrong path
# 1 of 4
September 10, 2010 08:33 (EDT)
Joseph Bodet
UpToDate has a patient information section which is generally excellent.  Patients can be referred to the site.  Additionally,  physician oriented material can be E-mailed with a free 30 day access to the subscription material.  Most general cardiology topics are represented and readable by the general public.  No advertising is present on the site and references are always presented.  A general information sheet on link on your practice website should discuss the hazards of unsubstantiated information on the Web.  The ACC is currently developing an excellent patient information section as well.  This can be accessed directly via CardioSmart http://www.cardiosmart.org/.
# 2 of 4
September 17, 2010 12:59 (EDT)
Scott

I find patients are very appreciative of being apprised of the latest

in trials and general guidelines that might apply to their condition.

It serves as academic exercise as well to be able to mention quickly

several alternative medications or treatments and why the one

chosen is seemingly the best.   I dont mind at all patients emailing

me and have upon occasion been surprised at something in the industry

that I might have otherwise missed.

 

There are too many horror stories these days about doctors not

keeping up with the latest developmentsand falling back on older

protocols.   If any doctor wishes to avoid the waste of time discussing

trials etc. then present the patient with the latest industry info that

is influencing his decisions and choices and to avoid needless repetition

of boilerplate data by distributing educational material directly

or providing links if the patient is internet savvy.

I know patients hate paying for scheduled visits where nothing has

changed and thusly the prescribed treatments do not change.

At least I can present them with some new info regarding

research taking place or new drugs being tested etc.   I want them

to feel like they have something to take home for their money

and I want them to never suspect that I might not be keeping

up academically. 

 


 

 

 
# 3 of 4
September 17, 2010 03:42 (EDT)
Denis

I agree with Scott, I myself manage and maintain one of these websites that has as a soul purpouse, is to help other DVT patients go throught the initial shock of having a clot.  Being one myself (a DVT survivor that is) I know what the newly diagnosed patients are going through. On the day you are diagnosed with DVT, you are bombarded with all these medical terms that you don't really understand, maybe because at that point you are going through the shock of having a clot and that you have been told that you were this close to dying from it (for some people) and you must admit, the terminology is not your every day person without a medical diploma terminology. How many people are aware what DVT is before they are actually hit with one? I know, I was one of those person.

All these things you are told to do, not do, when to do what you must stop doing, like some doctor do tell their patients that they have to stop eating green vegetables because it will interfere with their INRs, YES I had to tell many people that they don't have to stop eating their greens, but be consistant with their daily vitamin K intake. It's all about patient education that  doctors seldomly have the time to do.

We know that doctors are very busy and don't always have the time to make sure their patients do truly understand what they are saying. That is why I think that with today's technology we can help.   But as usual, the few sites that do not have the proper info will make a bad name for those who do know what they are saying.

Do I put down all doctors because a handfull of them don't know what they are talking about? No. I had a great medical team that was caring for me and made the best of what I had a big clot and now PTS, so I appreciate that and know that not all doctors are like them.

# 4 of 4
September 17, 2010 05:00 (EDT)
Carolyn Thomas

 

 The website WebMD alone gets over 40 million visits every month. Up to 80% of internet users have sought medical information online.  

But the amount of sheer unadulterated trash online is mind-boggling. That's why a reported two-thirds of patients apparently want their doctors to recommend reliable website resources for them. And if you don't recommend resources upfront and openly, believe me, we'll track it down for ourselves.

Medical Googling is not only for those patients who want to sincerely learn and ask questions about their own health, but online searches can also be a diagnostic tool for physicians.

Australian researchers reported in the British Medical Journal last summer on their study that chose 3-5 search terms for hard-to-diagnose illnesses, and then looked at how Google did compared with reports published in the New England Journal of Medicine. The study found that doctors who use Google to help diagnose difficult cases can find a correct diagnosis over 60% of the time.  

I wish that the ER doc who sent me home with an acid reflux misdiagnosis two years ago had instead tried Googling my symptoms (crushing chest pain, nausea, sweating and pain radiating down my left arm).  I’m now fairly confident that Google would have steered him to the correct MI diagnosis.  More on this at: "What Doctors Really Think About Women Who Are Medical Googlers" on HEART SISTERS - http://myheartsisters.org/2009/08/19/med-google/ 

The British Medical Journal also notes that doctors have been estimated to carry an astonishing two million facts in their heads to help them diagnose illness – but Google gives them quick access to more than three billion medical articles with a few clicks!

I would never expect my cardiologist or any other busy physician to be on top of every single trial or journal article. And that is also how I came to inform my cardiologist last month in his office that Plavix and Wellbutrin should no longer be prescribed together anymore, because, yes, I’d found the FDA Drug Alert online. But he told me that he had not yet heard about the Drug Alert – one full week after the warning had been issued.

So that non-STEMI patient coming in to confirm what he'd learned about Plavix/aspirin was actually doing you a favour by making sure you were aware of that study, too!  

I've found the Mayo Clinic's Heart Disease website to be of value for heart patients and their families.http://www.mayoclinic.com/health/heart-disease/DS01120   

 

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About Dr Seth Bilazarian
Seth Bilazarian MD has been a Clinical and Interventional Cardiologist at Pentucket Medical Associates in Massachusetts since 1993. He is board certified in Internal Medicine, Cardiovascular Medicine, Nuclear Cardiology, Vascular Ultrasound, Interventional Cardiology, and Vascular and Endovascular Medicine.

Dr Bilazarian performs coronary and peripheral interventions at Lahey Clinic and Massachusetts General Hospital. He has been an investigator in the interventional laboratory for new devices including drug-eluting stents, distal protection devices, imaging devices (OCT and InfraRed), and anticoagulant pharmacotherapy.

Dr Bilazarian is an active participant in clinical trials in congestive heart failure, hypertension, coronary disease prevention, prediabetes management, anemia, atrial fibrillation, and anticoagulation/antiplatelet therapies in the outpatient setting. He has authored numerous papers and book chapters in clinical cardiology. He was appointed as a physician advisor to the circulatory device panel of the FDA in 2008.
About this blog
My intent is to create a forum for dialogue on issues pertinent to private practice cardiology around topics such as:

  • Integration of new data and guidelines on inpatient and outpatient practice in clinical and interventional cardiology
  • Practice approaches to the extra clinical issues in dealing with managed care insurers
  • Strategies for navigating the restrictions of pharmacy benefits managers (PBMs) on pharmacologic therapies for our patients
  • Experiences with restrictions on testing and imaging
The video blog (VLOG) will provide an opportunity to share broadly different approaches to the common conundrums we face in caring for patients. My hope is that this forum will provide useful data points for practice outside of tertiary and academic centers and a look inside community hospitals and physician?s practice patterns in the office, starting with mine.