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LETTER
Year : 2013  |  Volume : 2  |  Issue : 2  |  Page : 209-210  

Patient education: Boon or Bane?


Department of Radiodiagnosis, NM Medical, Pune, Maharashtra, India

Date of Web Publication31-Aug-2013

Correspondence Address:
Chandrashekhar A Sohoni
B 5, Common Wealth Hsg. Soc., Opp. Bund Garden, Pune 411 001, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


PMID: 24479082

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How to cite this article:
Sohoni CA. Patient education: Boon or Bane?. J Family Med Prim Care 2013;2:209-10

How to cite this URL:
Sohoni CA. Patient education: Boon or Bane?. J Family Med Prim Care [serial online] 2013 [cited 2019 Aug 24];2:209-10. Available from: http://www.jfmpc.com/text.asp?2013/2/2/209/117431

Dear Editor,

The role of doctors in urban India is changing quickly, from making decisions for the patients to providing assistance to them in making informed decisions. Patients are becoming increasingly educated about health related issues, thanks to the World Wide Web. Though many research studies have shown better treatment outcomes with higher level of patient education, in the practical world doctors may actually feel otherwise. Today, many of us come across patients who do not hesitate to argue over complex medical issues without having much knowledge about the same.

Medicine is not an exact science. There are lot of intricacies and uncertainties involved in disease processes. To understand 'that' level of complexity, it requires thorough understanding of the subject. Every postgraduate medical subject has developed so much in terms of knowledge and repertoire that even doctors outside that specialty feel alienated! The very fact that continuing education is compulsory in medicine unlike other professions, tells us that medicine is an evolving, ever-changing, and a complex subject. This is not to say that other professions are easy and uncomplicated, but to emphasize that it is not easy to understand medical issues thoroughly for a lay person. And unless the issues are understood in depth, it is extremely difficult to appreciate the possibility of unexpected outcomes despite the apparent simplicity of the matter and expert medical care.

Prognosis after treatment cannot be guaranteed in terms of 'percentages' which patients normally expect the doctors to quote. Patients in urban areas are usually well-educated. Some of them are high-ranked successful professionals in their respective fields. It is a personal experience that some of these patients find it extremely difficult to come to terms with the fact that it is practically impossible for a non-medical person to completely understand the complexity of body physiology and disease processes. Anything short of an absolute, definite explanation fails to satisfy such patients. Anything that does not fit their logic is viewed suspiciously. They surf the internet, study the issue in their own capacity, and try to make conclusions. Again, it is difficult for a layman to decide which internet references to rely upon. Naturally, most of the references that patients quote are derived from patient-education related websites which contain over-simplified, superficial information, as against the complex but comprehensive information contained in randomized controlled trials and meta-analysis. Patients sometimes fail to understand that medicine cannot be simplified beyond a limit. In India, cultural influences and fixed notions about diseases greatly affect patient psyche. The growth of industries, rapid urbanization, and exposure to electronic media has given us a generation of financially well-off professionals who want the best service; no matter what the cost. Despite their education, sometimes patients fail to understand that money cannot overcome the uncertainties in medicine or human limitations. In fact, good education and financial well-being oddly seem to make this basic understanding even more difficult! It is sometimes surprising to see patients' marked inquisitiveness regarding modern medicine on one hand and equally sincere unquestioned following of nonallopathic medicine on the other hand.

The difference between urban and rural patients is becoming more and more obvious these days. Whereas, in rural areas there is still that element of trust and reliance upon a doctor's advice, it is fast disappearing in urban areas. The argumentative nature of urban patient population is starkly felt by an urban practitioner like me who has grown up seeing his doctor-parents practice in a rural area. Too much questioning by patients makes the diagnosing and treating physician apprehensive. No surprise then, as today doctors adopt a very defensive approach while dealing with patients. The mutual mistrust may also make doctors advise more investigations which in turn increases the financial burden on patients. Whereas a doctor is bound by an ethics code while dealing with his patients, there is no such ethical binding for the patients.

That patient education helps in disease management is a researched fact, but the overall impact that it has upon the dynamics of doctor-patient relationship and socioeconomic parameters may not be so easy to decipher.




 

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