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I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).
Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.
Providing additional health information is not always the best approach for physicians to assist patients, caregivers, and families, suggests an interesting perspective recently published in the New England Journal of Medicine.
Lisa Rosenbaum M.D., the New England Journal of Medicine's national correspondent, challenges the conventional wisdom that providing more health and medical information automatically empowers patients. Dr. Rosenbaum notes at times more information can be confusing, emotionally distracting, and actually undermine the goal to help patients make informed decisions.
Albeit tongue in cheek, Dr. Rosenbaum titles her perspective, 'the paternalism preference — choosing unshared decision making.' The title is provocative since empowering patient decision making is at the foundation of some U.S. federal agencies, such as the Patient-Centered Outcomes Research Institute, as well as health literacy initiatives, such as the National Academy of Medicine's Health Literacy Roundtable.
Full disclosure: I frequently participate in the latter Roundtable and NLM has been a member since its inception.
Yet, Dr. Rosenbaum makes some stimulating arguments about the clinical disadvantages of what she calls too much information.
For example, Dr. Rosenbaum describes a past encounter with an orthopedist when she broke her clavicle (or collarbone). Before deciding on a clinical procedure, Dr. Rosenbaum writes her physician mentioned several surgical options. She humorously writes (and we quote): '...despite my awareness that various surgical approaches exist, being asked by an expert how I want my clavicle realigned seemed like being asked by an auto mechanic how I'd like my clutch repaired' (end of quote).
Dr. Rosenbaum explains the current emphasis to provide more information to patients appropriately recognizes a need to engage patients in their own health care as well as respect patients' values. Conversely, she writes, (and we quote): 'the resultant approach ironically assumes a value framework not all patients possess. What if, for instance, the patient's preference is to know less?' (end of quote).
Indeed, Dr. Rosenbaum adds the more patients and physicians concede that comprehensive information sometimes has tacit disadvantages, the more health care providers may understand why some patients may not wish to receive complete information.
Given the current emphasis to comprehensively inform patients, Dr. Rosenbaum adds a core ethical question for physicians is (and we quote) 'As information-empowered patients assume greater responsibility for choices, do we (physicians) assume less?' (end of quote).
Dr. Rosenbaum suggests the best option for physicians is to hone an inner sense about how to share information, and to improve their recognition when patients seek more options, or prefer the recommendations provided by an expert. Dr. Rosenbaum adds too little research has been done about how diverse approaches to providing health and medical information shape patient voices, behaviors, and outcomes.
Overall, Dr. Rosenbaum writes (and we quote): 'The doctors I admire most are characterized not by how much they know but a sophisticated intuition about how best to share it' (end of quote).
Meanwhile, MedlinePlus.gov's evaluating health information health topic page reminds us that the most useful clinical information is based on current research. The evaluating health information health topic page also suggests how to find trustworthy information on the Internet.
For example, a link to a website from the Office of the National Coordinator for Health Information Technology (found in the 'start here' section) explains how to distinguish between reliable and unreliable health information. A gateway to help you find reliable medical information on the Internet (from the American Academy of Family Physicians) also is available in the 'start here' section of MedlinePlus.gov's evaluating health information health topic page.
MedlinePlus.gov's evaluating health information health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. You can sign up to receive updates about evaluating health information as they become available on MedlinePlus.gov.
To find MedlinePlus.gov's evaluating health information health topic page type 'evaluating health information' in the search box on MedlinePlus.gov's home page, then, click on 'evaluating health information (National Library of Medicine).' We also recommend three other health topic pages: understanding medical research, talking with your doctor, and health literacy. All three health topic pages provide insights into doctor-patient communication as well as interpreting and understanding medical information.
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