In the crowd

Slate asks, Should you crowdsource your medical problems? They say not so much:

…But few medical professionals are involved in patient sites; mostly patients just talk amongst themselves. That’s a problem since crowdsourcing works best when expertise is widely distributed. After all, it won’t help you much to have 1,000 people reading your mammogram or selecting your chemotherapy if they’re all well-meaning amateurs. What you’re really looking for is the consensus of 1,000 highly trained specialists. A patient working alone might be able to use the Internet to get a handful of credible second opinions, and nothing more.

It may be hard to get hordes of doctors to give you their personal attention, but you can often do the next best thing: Find out how hordes of doctors would help someone with a problem just like yours. In fact, the federal government and various groups like the American Academy of Pediatrics convene huge panels of experts to address medical issues all the time.

Setting aside the condescension, this is sound advice insofar as it goes. But I think the good doctor misses the point. Clinical guidelines are freely available, yes…but is there any reason to assume that lay people aren’t already availing themselves of these? I think it’s also worth pointing out:

  • “…panels of experts…all the time.” Really? Most clinical guidelines I know of are only updated every few years at best…they are functionally static
  • not everyone in the crowd is an amateur
  • crowds are populated by real humans  in real time…they don’t make you wait months for an appointment, they don’t make you fill out mindless paperwork, and they don’t demand co-payments

Crowdsourcing emerged because technology made it possible. And, I would argue, in health care it has taken hold because the current, antiquated system of solving medical problems is irreparably broken in many places. Patients are looking not only for cold clinical answers, they are looking for empathy, for responsiveness, for creativity, for attention, for time. But if doctors can’t/won’t even email their patients on a semi-regular basis, then it’s hardly surprising that their patients are looking for help elsewhere.

Please don’t interpret this as some kind of anti-doctor screed. A good physician is a tremendous resource.  I’ve been under the knives of two brilliant surgeons. And my GP is nothing less than a terrific doctor. She sees me on short notice. She relates to me as a human being. She encourages me to learn what I can on my own. She trusts me. When I brought her my genome scan, she was not threatened, she was fascinated. When I see her next and she learns that I’ve joined PatientsLikeMe (anxiety/depression…hi doc!), I expect that her reaction will be the same: curious, inquisitive, nonjudgmental. She understands that even crowds of “well-meaning amateurs” are not so easily dismissed.

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