There is no doubt the internet is one of the most powerful methods to gain information.  For the surgeon or the patient, the available information is completely overwhelming and makes sensible interpretation difficult, if not impossible.

The credibility of the sites and the information is not always clear. Patients are often desperate to find the cure or unorthodox approach and travel through endless documents until they find someone in cyber space who tells them what they want to hear.

It is not surprising, therefore, that patients frequently come to see surgeons with hundreds of pages of useless, poorly researched information, even advertising downloads, wanting the surgeon to spend hours explaining to them the pros, cons and deceptions they have read.  If this was done for all patients, only a handful of new cases could ever be seen in a day and a great deal of time would be wasted.

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There is a clear obligation and expectation that the surgeon will explain the options available, respond to appropriate enquiries and tailor the advice to the patient.  Alternative, untested, unproven options are not part of modern surgical practice.

Surgeons in Australian public hospitals are usually overwhelmed by waiting lists of patients needing to be seen and treated.  They spend much of their time trying to stay up-to-date with the latest literature, attend meetings, discuss concepts, ideas and views with colleagues.  If there was a new treatment that needed assessment, then they mount a study to ethically inform patients and report the results, good or bad.

Having expressed my concern for unassessed internet information, I am not suggesting that patients should not question and challenge their surgeons:  Why this approach?  Are there other legitimate options?   Could it be treated differently?   Why doesn’t the new provide better outcomes?

These questions should and must be addressed in advising the patient in the surgical consultation. Indeed, on occasions such a probing set of questions raises another series of options that can be considered, discussed and sometimes adopted.  If the best outcome is to be achieved, the patient with the surgeon should have a shared understanding of the risks, benefits and options of any surgical intervention and, indeed, non-surgical intervention.  While surgery has risks so, too, does failing to intervene.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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