Is Information Overdose Real?
By Josh Seidman | Popularity: 24%The social networking pioneer Dan Hoch (who co-founded the famous BrainTalk Communities site) posted a provocative commentary on e-patients.net today titled “Information Overload: Problem or Not?”
Hoch notes that the information overload across industries has given rise to the Information Overload Research Group, which is dedicated to “reducing information pollution.” I agree with Hoch that the Internet’s information democratization has been an important driving force behind what he terms the “e-patients movement.” No doubt that is a critically important contribution.
I would never suggest that consumers should be prevented from unfiltered information. But availability of all information on a topic does not equate with real access to meaningful, usable information for everybody. For some people, OD’ing on information may not be possible but many people would like to get guidance from other sources–that could be their personal physician, another health care professional, a community health worker, or another person who shares the condition.
As stated on this blog earlier in the week, Susannah Fox noted that Pew Internet Project data demonstrate that 80% of Internet health information seekers turned to a professional in a time of crisis, and that this figure is much higher than any other information that Pew studies.
Those of us who advocate for information therapy (Ix) never suggest that information should be available “by prescription only.” Information prescriptions are simply another tool, designed to help people navigate the vast information that exists in cyberspace and elsewhere.
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June 27th, 2008 at 11:20 am
Thanks for the shout-out to e-patients.net, Josh. I was just coming over to your site to find a link to point to from Dan’s post, b/c of this phrase from your conference speech: Ix helps people “titrate the dosage” of information. I think it’s important for you, Dan, and other people to find the common ground between “doctor knows best” and “leave the e-patient alone.”
June 27th, 2008 at 11:39 am
Susannah,
I think you’re absolutely right. And I’m pretty sure that people like Dan & I probably agree on 95+%. After all, I got into this work 8 1/2 years ago because I really believed (after all my years of working to improve quality by stimulating behavior of providers and health plans) that much more needed to be done to help consumers get access to the information they need.
I would love to figure out a way to work with all these different pioneers to find that common ground. Please post any ideas you have for facilitating that.
June 28th, 2008 at 7:57 am
I can’t help but chime in now, and add my thanks for all Josh’s great posts on this topic. The idea of common ground is really critical, I agree.
Tom Ferguson and I used to talk a lot about the fact that so many e-Patient group are downright hostile toward the clinician, because of their apparent intransigence. As an overreaction, even Tom used to sometimes feed into the idea that the traditional provider could be eliminated if we could only get enough information to the patient. I would counter that by trying to argue for a continued but different role for the clinician. That’s were this idea of “coach” came from (Ferguson’s word for the role).
All clinicians are ultimately patients, but not all patients are (traditional) clinicians i.e. there are more of them than of us. Change and control is shifting rapidly to the patient and I think this is great. BUT, this is supposed to be PARTICIPATORY medicine. Believe it or not, I think we are fighting to keep the clinicin as a participant.
June 30th, 2008 at 9:07 am
Dan,
Thanks for your post. There’s no doubt that the historical legacy of physician reluctance to bring their patients in as real partners has caused many e-patients to (rightfully) feel hostility toward traditional medicine. That’s part of why I like Paul Wallace’s story about the history of medical education that I paraphrased in my “Ix & the First Amendment” talk at the Newseum two weeks ago (full summary is on this blog’s June 17 entry):
“…A millennium ago, the professor just stood up at the front of the room and lectured didactically at medical students. After five centuries, Gutenberg invented the printing press and suddenly the students had access to the medical textbook too. This was a revolutionary democratization and shift of power that medical students could actually find the answers themselves. Of course, it took another half a millennium for consumers to have access to the information…”
…And, thank goodness!
Participatory medicine is absolutely a foundation of any future effective care delivery system. One thing that’s important is that should not mean that’s a signal for clinicians to bail out. Clinicians need to be able to serve consumers’ information needs, which will vary tremendously based on the individual consumers.
As patient-centered care pioneer Susan Edgman-Levitan said (in a recent IxCenter white paper available at http://www.ixcenter.org/publications/documents/whitepaper319.pdf): “What I run into frequently with patients when we talk about shared decision-making, is they get really nervous that we’re expecting them to be their own doctors.”
The consumer has to live with his or her health issues 24/7 and probably interacts with the health care system far less than 1% of the time (even for people with serious chronic conditions), so “providing” primary care is something that each individual ultimately is responsible for. Therefore, the consumer in most cases probably is the best person to serve as the primary care provider (if given the right tools), but that still may be very different from being a doctor. After all, “doctor” comes from the Latin “to teach”, not to “provide.” I think that participatory medicine hopefully can be about that bi-directional teaching and learning.