Thursday, August 13, 2015

Cultural Shifts, Biases, and Do-It-Yourself Healthcare

Our approach to healthcare has changed over the years. Healthcare providers used to have a paternal, authoritarian stance when dealing with patients. A few decades ago, it wouldn’t have been unusual to hear a doctor say, “Take this pill everyday and come see me in 2 months.”

Would you listen to your doctor if they told you that today? Maybe, but I bet you’d ask why, first.

We’ve had a recent cultural shift. The power imbalance between patients and healthcare providers is shrinking, and healthcare institutions now promote working with patients instead of just telling them what to do. We’re improving our communication skills. I believe that overall, we’re heading in the right direction.

However, I also believe that our cultural shift is a double-edged sword. People are trying to solve their own health problems. I’ve seen a fair number of cases where patients self-medicate with products (ex. herbals) recommended by friends, commercials, or the internet. Patients rarely share this to healthcare providers unless they’re explicitly asked. It’s usually not a big issue, but in some situations self-medicating can be dangerous.

The problem with having patients make completely independent healthcare decisions is that humans are naturally weak in sorting out good information from bad information. We’ve got too many biases in our way. These include:
  • Confirmation bias: We tend to look for information that lines up with our beliefs, and ignore everything else.
    • For example, a man distrusts medications. He sees a new headline that says, "New heart medication works great; but it may cause muscle pain." He says to his friends, "Muscle pain? I knew these drugs were bad for you," ignoring the protective effects of the drug on the heart.
  • Availability Bias: We give more attention to personal stories and examples. We give less attention to impersonal numbers and data.
  • Anchoring Bias: We rely too heavily on the first pieces of information we get.

Overcoming these biases is hard.

Things become especially complicated when the internet is involved. People have mastered the art of Google-Fu, but the internet isn’t well-regulated. It’s incredibly easy to find false or misleading information. When looking online, it’s essential to be skeptical and to question what you read. When in doubt, check with your healthcare provider. You’ve got no real idea of what to expect when you act on 1 hour of online research. There’s a bit more leeway when you follow the advice of someone trained to give standardized care.

I think it’s excellent that people look things up for themselves. It's empowering to take control of our own health, and there's certainly a lot of well-written information out on the web. However, we've got to be responsible in how we handle that information. 

As always, please feel free to provide me with any comments or feedback. Otherwise, I’ll see you in my next post!