The “DocPatient” blog, by Dr. Louis Cornacchia of Doctations, has quite a tagline:

Internet healthcare is inevitable. Done right, it can initiate enormously positive change in the U.S. healthcare system. The only way for it to be done right is for doctors and patients to work together to make it happen.

Sounds like participatory medicine to me!

And my Google Alert just popped up a post he wrote shortly after the conference: “Doctors Are Killing Their Profession, the Healthcare System and Their Patients with Paternalism.” Even I wouldn’t put it that strongly, but then I’m not an MD – and I’ve certainly never been through medical training, about which he says:

Every day, medical schools indoctrinate upcoming doctors with paternalistic behaviors. “Your patients don’t want to know the details, they want to get well, its your responsibility to make them well.” “You, doctor, should shoulder the responsibility.”

About paternalism itself, he continues: 

Paternalism … is the most critical problem underlying the healthcare crisis. Until we eradicate paternalistic behavior and form balanced, collaborative relationships with our patients, no federal or state regulations will be effective in improving quality or reducing costs. It takes two to do healthcare, and it takes mutual respect and recognition of the patient as a “partner” to do it right.

If you’re not familiar with what paternalism looks like, in healthcare, read his entire post. (It’s not long, and it’s clear.)

I was exposed to paternalistic doctors early in my adulthood, and I elected to leave them; I’ve always wanted to be listened to, respected, empowered and enabled in any professional relationship. So it’s felt odd to hear recently from so many people that paternalism is still so widespread. But I guess it is, and any patient who wants to wise up should be able to recognize it. Read the post for examples of what it looks like on the hoof – including a rather chilling example of how his wife was treated during chemo.

Dr. Cornacchia’s company (Doctations) offers a doctor-patient practice management system, so I suppose someone could say his words are colored by commercial interest. I think it’s the other way around: he saw the future and made a system to match:

The argument about which takes primacy—physician beneficence or patient autonomy—is over. It is now clear that “the right of the patient to act autonomously always outweighs obligations of beneficence toward the autonomous patient.” … The path to better healthcare starts here.

The author is Amy Romano @MidwifeAmy, a nurse-midwife and advocate for mother-friendly maternity care. An expert in research analysis, she manages the Science & Sensibility blog for Lamaze International.

Amy found us through social media, pure and simple: she was out there doin’ her job, chasing interesting chains of followers, and ended up here. She read the white paper and immediately saw that it’s a perfect fit for what she’s up to. Look: social media brought together a growing idea and a constituency that’s ready for it.

Running with the ball herself, she’s now written perhaps the most profoundly innovative post I’ve seen since I first discovered the e-patient movement: she observed that almost everything in the e-patient white paper is about disease. And as the Lamaze people are well aware, a whole lot of healthcare goes on in (what should be) the non-pathological area of maternity and birthing. And those moms-to-be just happen to be in the actively-engaged online demographic: a perfect setup for participating e-patients.

Hold onto your hats, folks. This is a good one. :–)

Update: Amy’s post is here.