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SPM member Sue Woods, of Oregon Health and Science University and the Veterans’ Administration, has posted a terrific response to’s “Ten dumb things you do at the doctor’s office” and to our discussion of it here. Titled Dumb patients? No way. It’s only normal behavior and status-quo clinical care, it’s great.

For each “dumb thing,” Elizabeth Cohen’s original included why patients should wise up; Woods proposes what she feels is a more empowering version, and advice for docs.Example, for the #2 dumb thing:

  • Problem: “You lie.”
  • Original comment: “I need to treat you the best way I can, so if you’re gay, tell me. If you drink a bottle of tequila every night, I need to know… I won’t judge.”
  • Sue’s version: “You have the right to not share things. If you decide to hold back, make sure it’s for a good reason. Ask yourself why you don’t want to share. Are you afraid you’ll be judged? Lectured at? If so, say someting like “I want to tell you something, but I’m not sure how you’ll respond.” That’s a signal for the doc to listen and not react. If they behave badly, vote with your feet.”
  • Sue’s note to docs: “It’s your job to make people comfortable so they share their stories. People have a right to not disclose, but if you build trust then sharing happens. Listen and don’t interrupt unless it’s necessary, and make the visit about the patient’s agenda. If you find discrepencies in a patient’s story from one visit to the next, get over it. We tell different stories about ourselves all the time.”

This doesn’t just empower the patient (putting responsibility, knowledge and power where it belongs), it does it in a non-blaming, explanatory way. And it empowers the doc, in the same way: putting power, knowledge and responsibility right where it belongs.

This could be the start of a “How To Be An e-Patient” book. Or, better yet, booklet. Pocket-size. Handy. Concise.


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