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« Dr. Carey Nease, Southern Surgical Arts In Chattanooga, TN | Main | Posting Comments On Medical Spa MD: Do's & Don'ts »
Tuesday
Jul172012

Is Technology Changing The Doctor-Patient Relationship (for the Worse)?

The first point of contact for a patient to ask post-surgical questions should be the surgeon who performed said surgery. The trend seems to be in exactly the opposite direction.

I've noticed a concerning trend. I participate in websites like RealSelf.com that connect plastic surgery patients and cosmetic surgeons. These sites are allowing patients to have near immediate access to expert plastic surgeons from across the nation and plastic surgeons to interact with potential patients.

In the past few months an increasing number of patients in the early post-operative period (some with dressings still in place!) have posed questions to “online surgeons” seemingly before seeking follow-up with the plastic surgeon who just performed the procedure. It is concerning that a patient would seek advice from a surgeon they do not have a doctor-patient relationship with and who is unfamiliar with the specifics of the surgery that they've recently undergone. Patients have even gone so far as to inquire about where to seek second opinions and whether revision surgery will be necessary all within the first post-operative week.

The early post-operative timing of this phenomenon is most concerning. This is the period in which we need to reassure our patients that bruising and swelling will resolve, dressings and sutures will be removed and that they truly will look great once they’ve healed. This period can cause patients significant distress and many require a lot of hand holding at this point.

We’re obviously failing some of our patients if they're reaching out online during this period instead of calling our offices and dropping in to be evaluated. I agree that second opinions are highly valuable and would not hesitate to arrange such for a concerned patient. However, a patient-initiated second opinion from an unfamiliar, online surgeon who has an incomplete picture of the patient's history is problematic at any time point let alone while the compression dressing is still in place!

What could possibly be responsible for this trend? As cosmetic surgeons are we so difficult to reach that our patients need to seek online advice from others? As we become more amenable to interacting with potential patients online are we failing to care for those who have already made a trip to our operating room? Is it simply easier for our patients to log onto a website rather than call the doctor's office? What can we do to direct those online inquires back to our own practices rather than into the digital ether?

As a Facial Plastic Surgery practice, my entire team is in the business of building relationships. If a patient has a professional, responsible and ethical plastic surgeon, the first point of contact to ask post-surgical questions should be the surgeon who performed said surgery. This trend seems about as far astray of that goal as one could imagine.

Has anybody else noticed this trend online? Have you experienced this with one of your own patients? What you have done to prevent this from happening in your practice? Please contribute your thoughts.

Reader Comments (9)

I think you're exactly right with this post. I've seen a number of patients who have come in post treatment 'armed' with information that they'd looked up on line. While I don't think that this is necessarily bad or even unwanted since I want my patients to be fully informed, it can lead to difficulties and issues when another physician provides conflicting advice or information. This is a really touchy subject and I'd be interested to hear others opinions.

07.17 | Unregistered CommenterDermgal

Reading this post really touched a nerve. We had a patient last week who came back to a followup who came in with a print out of some physician comments from RS and was oddly combative, and second-guessing her decision. While I've known this patient for a long time I was caught off guard. It ended OK but there were some oddly awkward moments since I was essentially responding to very specific comments. Like I said, it could have been worse but not something that would have happened a few years ago.

07.17 | Unregistered CommenterRogerEn

Thank you for your comments @Dermgal and @RogerEn. I think that this is a trend that will continue to grow and we will need to manage it somehow. Unfortunately, an online consultation does not provide enough information or imaging to give patients an accurate assessment. Thus, it's a setup for misunderstanding and something that might complicate an already stressful post-surgery recovery.

I read these comments with some apprehension. I feel somewhat fortunate that we haven't yet advanced to the social technology level in Rio that enables these kinds of ratings sites where doctors are telling patients on the internet what should be their results. It will come but perhaps there will be better solutions by that time. Thank you for the discussion.

07.18 | Unregistered CommenterDSilvaMD

I love this discussion. My doctor is always available for his patients and they know that so they have always reached out to us but I must say a lot of new patients come in with knowledge from the internet and are more informed than ever which sometimes makes communication a lot easier regarding their surgery. When they insist on believing what they have read I will check it out with them right there in my office and it can make for a good conversation - if one has the time that is! My feelings on this are, if the patient is insistent on knowing more than you then they should probably be referred to another practice.

Medicine is changing and we have to take advantage of the technology. A 30 minute online consultation is more worthwhile than a 5 minute spot check up which is more of a hello-goodbye conversation.

I still believe that online interactions shouldn't take the place of face-to-face physician encounters. It is of utmost importance to ensure delivery of healthcare services.

02.1 | Unregistered CommenterTOrrenia

It would be nice to be able to offer an online consultation here in UK. Currently this is not an option being offered to NHS clients.

02.27 | Unregistered Commenterlauren

Are there any associated malpractice risks if you don't see a patient in person?

03.6 | Unregistered Commentertjr

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