I have posted notes in the past about the topic of converging access to medical knowledge by which I mean that physicians, healthcare consumers, and patients are often acquiring medical information from the same source (see: All Media is One: Convergence and Accessibility of Medical Knowledge). In this note and as evidence for my conclusion, I cited the long-standing access of consumers and patients to PubMed which is an archive of medical journal articles. I just recently learned that healthcare consumers and patients can now pay a modest fee for the same access to UpToDate that physicians enjoy. Here is how this web-based service describes itself on its home page:
The UpToDate community includes our faculty of more than 4,000 leading physicians, peer reviewers, and editors and over 360,000 users. Our faculty writes topic reviews that include a synthesis of the literature, the latest evidence, and specific recommendations for patient care. Our users provide feedback to the editorial group. This community's combined efforts result in the most trusted, unbiased medical information available. Patient/consumer subscription options for UpToDate include the following two choices: One-month (30 day) subscription ($44.95) and one-week (7 day) subscription for $19.95.
As noted in the company's self-description, it provides an integrated synthesis of the medical literature by topic accompanied by specific recommendations for care. Its assertion that it provides the most trusted, unbiased medical information available is not marketing hype -- it's an outstanding resource. In fact, it is so authoritative and the prose so dense that I suspect that even some physicians may have difficulty wading through some of the entries. So we now arrive at the moment of truth. Patients and consumers, for a modest fee, have identical access to the same information about diagnosis and treatment available to physicians. How, in fact, should they leverage this access to increase their chances for optimal treatment in our healthcare environment?
If I were a healthcare consumer with a diagnosed serious disease, or in the early stages of the diagnosis of one, here's what I would do:
- Subscribe to UpToDate for one month (or more as necessary).
- Work my social network to find the best physicians I could find who would be willing to sit down with me in front of the computer and review the relevant entries in UpToDate regarding the diagnosis and treatment of the disease.
- Such physicians should be as neutral as possible regarding my diagnosis and treatment, which is to say that they would have no stake in the outcome of the discussion other than as a friend.
- I would develop an understanding of the optimal diagnosis and treatment plan for patients such as myself, taking into consideration factors such as age, financial status, and tolerance for risk.
- I keep these facts in mind, and refer to my notes, as I discussed the various options presented to me by my physicians.
For some patients, a preliminary first step, rather than paid access to the physician side of UpToDate, could be its free patient portal that comes equipped with its own search engine. This service provides access to medical information tuned for a consumer audience. If this material proves to be insufficient, there is a link on the patient portal page to subscribe to "physician-level" information for a fee.
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