Third question: are we well-informed?
If we want to take care of ourselves in an intelligent way, we must be well-informed about our disease and able to follow and participate in technical discussions with our specialists.
Not limiting ourselves to the opinion of the physician who is treating us and asking for a second opinion is already a way to better understand our situation. It is good practice to do this not only in the beginning but every time that the situation changes and there is an important decision to make. It is better to ask for a second opinion online, not only because in this way we can avoid to travel in vain but also because doctors work better when interacting remotely.
In order to ask for a second opinion online the doctor who is treating us will have to write a full clinical report and formulate precise questions. The doctor who will give us a second opinion, in turn, will have to describe the situation from his or her point of view, give suggestions and argue his opinion in writing. This job forces doctors to think and reason in a systematic manner which is usually difficult to do during a medical examination.
A second opinion online is also advisable since the contact between the two specialists is kept more impersonal. In this way, if the physician who is asked to give a second opinion disagrees with the ideas of the doctor who is treating us, he or she will express it more easily. In medicine there is a certain tendency to avoid to openly disagree with a colleague’s opinion, thinking that this means following professional rules and be respectful with professionals of the same field. Marty Makary, doctor and professor at John Hopkins University, in his book Unaccountable, talks about the ‘code of silence’.
If the physician who is treating us does not want us to ask for a second opinion or is annoyed or offended by this, we must seriously consider whether to change oncologist. We might not be in good hands.
We should also study on our own and read about our disease and the possible treatments available. The Internet is an extraordinary resource. Sometimes doctors advise patients and their family against this. They fear that people will get lost in the sea of information accessible on the Internet and that they can be misled by unfounded statements found on the network. This risk exists but it is not a good reason to give up our research on the Internet.
One can understand that doctors sometimes find it hard to deal with patients who lose their way in all the information available on the Internet. It is understandable why they wish that their patients refrained from using the Internet, thus demonstrating a sort of nostalgia for the past. Nonetheless, access to information on the Internet is part of our life and contemporary society. A better world can certainly not be a world made of healthcare obscurantism. It is clear that we must try to make patients use the Internet adequately, so that they can be well-informed and develop their knowledge and so that physicians and patients can openly and calmly discuss about the information found, thus making this an opportunity for a constructive dialogue and to grow.
If we know how to proceed, research can helps us. We can become competent enough to actively participate in the discussions concerning us and to make sure that we pursue an intelligent care. We must proceed step by step, evaluate critically the information and the sources, bridge those gaps in our basic knowledge that prevent us from fully understanding what we are reading. Let’s not give up hope we do not need to be doctors to find our way in medical problems. It is enough to follow an adequate scientific approach. The scientific approach is a basic skill that we might already have because we have developed it in other fields. If we do not already have it, we can develop it if we train ourselves and if someone more skilled than us helps us.
Physicians who are treating us can help us to evaluate the information that we find and to improve more and more our research skills. Let’s make them work through a wise and constructive communication. Let’s ask for their help humbly and politely and let’s encourage them to discuss the things we have found out, one by one. If the person who is treating us, in spite of our best efforts to start a discussion about things, obstructs our wish to seek information and ponder the problems together, let’s ask ourselves whether he or she is the right specialist for us.