How Empowered Physicians Can Embrace e-Patients

20x26" e-Patient Poster

Many e‑Patients are actually unfamiliar with the term.

EPATIENT In casual conversation, everyone to whom I mentioned the word "e‑Patient" has either never heard of it or has misunderstood the definition; this should not be the case since, in many countries, they outnumber what is commonly thought to be the traditional passive patient.

More physicians are embracing e‑Patients. Not too long ago, it was common for doctors to carefully conceal medical research from patients. Some regarded this behavior as upholding their hypocratic oath. Today, an increasing number of physicians are using social media and most patients are researching their health concerns before or after doctor visits. Kaiser Permanente integrates secure e-mail, patient lab history, physician profiles and medical glossary into its member site. Hence, savvy healthcare providers are partnering with empowered patients to engage in more productive consultations.

Anatomy of An e‑Patient

An e‑Patient is optimally one who is equipped, empowered, enabled and therefore engaged in cooperative healthcare. Though the provenance is not limited to the Internet, this international resource has, to a large degree, been the impetus shaping the proliferation of modern e‑Patients. The term is gaining traction but personal definitions of an e‑Patient vary. With four loosely defined categories, [1] perhaps you are an e‑Patient and don't even realize it.

Group 1: Accepting Group II: Informed Group III: Involved Group IV: In-Control
Doctor-dependent and uninformed Doctor-dependent but informed Junior medical partner Autonomous patients
Consider their doctors to be the ultimate medical authorities. Feel it is their doctor's perogative to provide any medical information they need and to make all their medical decisions in their behalf. Rely on clinicians to make many of their medical decisions but they are more likely to go online to learn more about heir condition and its treatments to keep from "wasting the doctor's time with their questions." Fairly well-informed and somewhat involved in personal healthcare. May not be particularly assertive in voicing disagreement with their physicians over a medical diagnosis or treatment. Often manage own medical tests and treatments, even if clinicians disagree. May attempt to help physicians keep up to date with medical treatments. Generally involved with support groups or online patient communities.

The "accepting" patient is compliant but does no research so actually cannot actually be termed an e‑Patient. Hence, e‑Patients are defined in the remaining groups II through IV, ranging from modestly "informed" to "autonomous." There are even variations of the latter, ranging from conscientious to confrontational.

They're looking for best treatment options for a diagnosis or have symptoms of a condition that doesn't fit the original diagnosis.

Over 60 percent of e‑Patients have accessed user-generated health information and say the information found online affected a decision about how to treat an illness. Over 80 percent of Internet users have looked online for health or medical information. [2] Peer-to-peer (P2P) patient data is a growing movement, allowing patients with identical illnesses to disseminate resources and receive compassionate support. [3,4] These e‑Patients have either accepted a diagnosis and are looking for best treatment options or have symptoms of a condition that doesn't fit the original diagnosis.

One advantage of patients empowered with appropriate medical information is they possess a broader understanding of treatment options and outcomes of a diagnosis. Physicians who partner with patients can have more productive conversations. When e‑Patient Dave was diagnosed with stage-4 kidney cancer, he proactively beat the odds.

What is Your e‑Patient Policy?

Medical offices cannot just assume that most of their patients are not Internet savvy, nor can they presuppose that anyone that does medical research is fanatical. When faced with nagging symptoms, an e‑Patient may research several possible diagnosis. There may be trepidation over presenting findings since physicians might misinterpret the intentions — erroneously concluding that the patient is fabricating illnesses. (See Munchausen Caution sidebar.) Interaction may become confrontational, as the doctor quickly dismisses all suggestions without thorough evaluation, or on the other extreme, orders numerous tests to rule out everything discussed.

Policy : Doctors with no patience for e‑Patients may soon have no patients.

Kevin Pho, MD posits, "Our health system does not promote the communication necessary for physicians to engage e‑Patients... Patients, on average, are interrupted less than 20 seconds after they start talking." [5] Often what is needed is a few extra moments to flesh out what may be happening and calmly explain and rule out, with mutual feedback, possible diagnoses and treatments. A shy patient is more likely to have concerns but not voice them, in hopes that the doctor will arrive at the suspected conclusion. When that conclusion is not addressed, the patient may visit other doctors.

Displaying an e‑Patient policy poster minimizes apprehension and allows patients to speak freely with physicians. offers two of the most important patient posters a medical office can display. Anatomy of an e‑Patient acknowledges that empowered patients are understood, loved and welcomed. Office Policy for e‑Patients goes further by presenting guidelines for optimum patient/physician interaction.

Tags: anatomyPoster, ehealth, entitled, epatients, participatory medicine, support

  1. Society for Participatory Medicine. e‑Patients: How they Can Help Us Heal Healthcare - White Paper.
  2. Client Infographic: The Empowered e‑Patient. Pew Internet and American Life Project, 2009, 2010.
  3. e‑Patient Demographics. e‑
  4. When Patients Share Medical Data Online. Time Magazine.
  5. Op-ed: Empowered e‑Patients are failed by our health system.
  6. Munchausen syndrome.