Health Information Explosion

This philosophy is one that the vast majority of physicians have adhered to for years. Although patients can receive educational materials in a dramatically different ways now, printed materials remain the format of choice for most rheumatologists.

What Do Rheumatologists Use?

“I think it is still important for patients – especially older ones – to be able to hold something tangible in their hands that they can read and mull over,” says William P. Docken, MD, assistant professor of Medicine at Harvard Medical School and medical director of Brigham Orthopedics and Arthritis Center at Chestnut Hill in Massachusetts. Dr. Docken predominately uses patient fact sheets printed from the ACR Web site.

“These electronic fact sheets are among the most frequently visited sections on the ACR Web site,” says Kristine M. Lohr, MD, professor of medicine, associate chief in the division of rheumatology and associate dean for outcomes research and improvement at the University of Tennessee Health Science Center in Memphis, and chair of the ACR’s Patient Education Task Force.

“At UCLA we have an entire display board of Arthritis Foundation brochures and sheets from the Paget’s Disease Foundation, as well as specific pharmaceutical print materials for our patients,” adds Roy D. Altman, MD, professor of medicine in the rheumatology and immunology division at the University of California, Los Angeles (UCLA). “When I administer injectables, like an intraarticular hyaluranate, I always give the patient oriented brochure and the package insert to the patients.”

Other rheumatologists have jumped from DVDs to more interactive patient education on the Internet. “We have stopped using DVDs in our office because much of our patient education is now Web or computer based,” says Eric S. Schned, MD, a rheumatologist at the Park Nicollet Clinic in Minneapolis, Minn., and a member of The Rheumatologist’s editorial board. “I store educational materials on my laptop and print them out for the patient during the exam. My colleagues and I have organized our own departmental Web page from which I print disease, medication, laboratory, exercise, and other information pieces. I also download pages from other Web sites. We keep a significant amount of printed materials in our hallways and on bulletin boards in the exam rooms that patients may read and take home.

“When I’m with a patient in the exam room, I will pull up an image that I want to demonstrate, such as a picture showing a joint with synovitis, and turn the laptop around so they can see the screen,” adds Dr. Schned. “All of our imaging is now online, so I’m also able to pull up the patient’s X-rays and MRI or bone scans so that they can see their own results.”

Regardless of the format, these rheumatologists agree that education materials must reinforce what the physician discusses with the patient. “Since patients are generally too anxious in the office to truly comprehend what was said,” notes Dr. Docken, “I like to point out the items that are relevant on the fact sheet, so that they can review the information when they get home.”