"I’m frank with them. If it’s something I haven’t heard of, I tell them. I also tell them where I get my information," says Kevin Krughoff, MD.
“Lately, patients are asking about shock wave treatment for Peyronie [disease] and erectile dysfunction. Sometimes the information even comes from health care professionals.
The other one is ‘electrical impulse generators,’ like applying an electrical current to rehab muscles in physical therapy. Patients want to know [whether] it works for stress incontinence.
I’m frank with them. If it’s something I haven’t heard of, I tell them. I also tell them where I get my information. We want a good relationshipto make sure patients know we understand their frustrations, and [we] want to help.
Useful resources include the Urology Care Foundation site and [American Urological Association] pamphlets. There’s a lot of good information on the Internet, but patients should question where it’s from and why they’ve come across it. There are different incentives for [individuals] to dispense information.
I tell patients, ‘I don’t think shock wave treatments will help. It costs a lot of money, and you might get hurt.’ They appreciate that candor.
I can’t advise them against something I haven’t heard of. I tell them if it’s not in the journals I use to guide my decisions. [Patients] have a right to explore as they want, but as somebody who’s going to advocate for them, I tell them the best quality of information comes from certain sources.
They come back when treatments don’t work. I don’t turn them away if they don’t follow my advice.
I tell them [that] if something doesn’t work, [then] come back and we’ll work it out. Don’t be ashamed. We’re doing this is a team.”
Kevin Krughoff, MD
“I see it quite a bit. We joke [and] call it ‘Dr Google.’ The key is understanding why they go hunting for information. We’ll review their information, then I’ll say, ‘I understand why you looked, but that’s not accurate.’ I direct patients to more reputable websites if they’re going to hunt on their own.
I believe the old Burlington Coat Factory commercial [phrase]: ‘An educated consumer is our best customer.’ When they’re preeducated, it makes conversation easier because they’re familiar with the terms and concepts. When they have misinformation, correcting it is OK, but they need to understand where the conversation is going.
Currently, we’re hearing that apple cider vinegar is good for kidney stones. I tell them that isn’t accurate and ask where they heard it. It’s [usually] a home remedy website. We explain apple cider vinegar has never been shown to affect kidney stones.
If it’s minor misinformation, I’ll say, ‘That’s not the way it works, but let’s talk.’ If it’s gross misinformation that came from another doctor, I’ll say, ‘That’s absolutely not correct.’ Depending on the severity, I’ll spend a lot of time and be firm, because they’ll say, ‘But another doctor told me.’ The source determines my response. [Because] patients tend to trust other physicians, it requires a stronger response.
I’ve had to tell [patients that] something is absolutely, flat-out wrong. When that happens, it usually comes from emergency [department; ED] doctors. I just tell patients [ED] doctors are there to make sure it’s nothing bad; I’m the urologist. This is my area, and I’m telling you it’s wrong. Patients generally accept that.
The problem has been getting worse over the past several years, because patients don’t trust physicians as much as they used to.”
Jonathan Block, MD
New Hartford, New York
“It’s difficult sometimes with ‘Dr Google,’ as I often call it, especially with a diagnosis of cancer or something like that. After hearing that, [patients will] do a Google search, and it can be difficult to sift through all the information. Some of it’s good; some of its bad. Depending on the patient’s education, sometimes they come back with good questions, and I can explain what the data mean. Sometimes they misinterpret information and get the wrong idea altogether.
It’s a challenge because there’s so much information on the Internet. When the patient gets any diagnosis, even a kidney stone, the first thing they’ll do is get on the Internet and come back and saying, ‘I want that apple cider vinegar that dissolves this.’ I have to tell them there’s no such thing.
It’s particularly challenging with over-the-counter products, like testosterone enhancement—that’s probably the most common misinformation out there. ‘Can I take this pill that’s on the Internet to increase my testosterone and make me young again?’ I tell them, ‘They sell a lot and none of them work. Don’t waste your hard-earned money.’ Everyone wants to make sure they spend their money and resources wisely.
Our role is to guide them through this stuff that’s out there. Patients respond well to that. We still have a lot of credibility among the public, so when the doctor says something, in the heart of Indiana and Kentucky, patients still listen to us and will do what we say. We’re lucky in that sense.”
Bradley Bell, MD