Information Economy

One of the ideas that Freakonomics touches upon is that of an information economy. For the most part, doctors deal in an information economy. When a patient goes to their physician, they want to know what is causing their rash or cough or fatigue. The doctor, a veritable repository of facts, deduces from the history, physical exam, imaging, and laboratory tests an answer, and they can proceed to treatment. We go to four years of medical school and three to eight years of residency to develop such a fund of knowledge as well as the tools to know how to ferret up knowledge we don't have. The "thinkers" in medicine such as internal medicine doctors deal with this information economy.

This is changing. The Internet is here to stay. Patients google their symptoms, peruse websites, post on message boards, and find support groups online. The vast information gap between physician and patient is closing, at least for the educated patient. Frequently, I see patients who have already done their research and come up with conclusions.

What does this mean for medicine? I'm not sure. Patient empowerment is a good thing, but we will have to see how empowering the Internet will be for consumer understanding of medicine. Information gleaned from the Internet may be biased, out-of-date, incomplete, false, esoteric, or too complex but this may not be readily apparent to the general public. Doctors will have to struggle with convincing patients that they know better, or on the other spectrum of things, conceding that they know less than the well-researching patient. This is somewhat disconcerting. The information economy of medicine is crumbling, and doctors that I have spoken to vary a lot in their reactions. Some don't like it. Others welcome it. Most adapt.