Sometime around 1998 in the Texas Medical Center.
DrV: (enters exam room) Hey, How are you? I’m Bryan Vartabedian (extends hand).
Father: (arms crossed, smiling, leaning against wall) Oh I know who you are, Doc. And I know where you went to school, where you’ve lived, if you’ve been sued and a few other things. And I’m fine, by the way.
DrV: Um, Okay. (Shakes hands with father. Looking to child, scruffing his hair). And this must be Caleb.
An odd moment, for sure. When it happened I didn’t know what it was about. After similar encounters I understood. It was about where patients found themselves in the early days of the information revolution. And there was the father who wheeled into the exam room two large boxes of printouts perched on a dolly. Inkjet validation of his role in the decision about his son’s surgery.
These situations illustrate the ‘information show of force,’ a phenomenon that I witnessed in the mid 1990’s when patients assumed the power to search not only their doctors but everything about themselves. After generations of information control by physicians, patients could now see what their doctors could see. And they could see all about their doctors.
The show of force was less about information as much as what it represented: a new role in an old relationship. Like hammers on the Berlin wall, information was the tool that began to break an old model. But understanding information’s power and limitations has its own learning curve. There have been awkward moments. Caleb’s father, for example, wanted desperately to show that he had a card to play.
The information show of force ultimately faded. Now, nearly 15 years later, it seems patients have developed a more mature, sophisticated relationship with their information. Digital natives are now digital moms and patients are more accustomed working with and around data. A new generation of doctors has begun to replace the pre-digital set. And like reception areas, exam table paper and the smell of alcohol wipes, information is part of our healthcare landscape.
I think it’s these small elements in medicine’s transition that help us remember where we’ve come from.
The scenario presented here has been altered/de-identified/fictionalized to protect the dignity/privacy of the patient and parent.