Changing Dynamics in Doctor-Patient Relationships

A few years back, Jenny Ip found herself in a cardiologist’s office after discovering her cholesterol levels had risen significantly in her blood tests. She recalled that the doctor asked about her lifestyle before suggesting a statin medication. However, Ms. Ip, now 46, wanted more tests before starting any new medication. Her doctor didn’t think that was necessary, so she decided to take action. Ms. Ip sent him a podcast episode from “The Peter Attia Drive,” specifically noting the timestamp for the segment she wanted him to hear.

This interaction reflects a broader trend happening in exam rooms nationwide. Patients are increasingly coming prepared to discuss health topics they’ve researched through podcasts, influenced by platforms like social media and ChatGPT. Interestingly, about half of U.S. adults under 50 seek health advice from podcasters or online influencers. Some popular health podcasts, such as “Huberman Lab” and “The Ultimate Human with Gary Brecka,” are attracting over a million listens per episode.

Many individuals view podcasts as a tool for taking control of their health, especially when faced with busy doctors and rushed appointments. This shift also hints at a growing skepticism that some patients have towards medical professionals and their assessments.

“I know myself better,” she remarked. Thanks to her persistence, her doctor eventually acquiesced to more tests. Instead of resorting to medication, Ms. Ip tried adjusting her diet. She found her cholesterol levels improved.

Doctors are beginning to adapt to this new landscape, with some even endorsing podcasts. For instance, Dr. Dipesh Gopal, a general practitioner from Queen Mary University of London, sometimes “prescribes” podcasts he has vetted, finding them more effective than handing out printed materials to educate patients about their conditions.

On the flip side, doctors are also having to combat unwarranted ideas promoted by influencers lacking relevant medical credentials or those possibly pushing a product for profit.

Dr. James H. Stein, a cardiologist at the University of Wisconsin, mentioned a scenario where a patient walks in, confidently stating, “I have advanced heart disease—I need a coronary CT angiogram and a homocysteine level test.” Such encounters can leave him feeling more like a technician than a medical expert.

Mataya Dade, 33, has experienced both the positives and negatives of gaining health information from podcasts. Diagnosed with breast cancer in 2023, she was convinced by podcast clips that she had developed drug-induced lupus due to her immunotherapy. This belief sent her into an anxious spiral until she spoke with her doctor, who clarified that such complications were unlikely in her case.

However, she found some podcast information beneficial. After learning about a specific test that monitors cancer recurrence through blood fragments, she asked her oncologist about it. While her doctor explained it wasn’t recommended for everyone due to potential over-reliance on the results, she agreed to order it for Ms. Dade every few months.

Ms. Dade left that appointment knowing why her doctor hadn’t offered the test initially, but she appreciated feeling heard. “The ball was back in my court—as it should be,” she noted.

Dr. Ilana Yurkiewicz, an oncologist with Stanford Medicine, appreciates that people are taking steps to educate themselves, acknowledging that health decisions often happen outside the clinical setting. She finds the accessibility of podcasts appealing, particularly for those frustrated with traditional healthcare systems.

Yet, Dr. Yurkiewicz has also witnessed how misleading or incomplete advice from podcasts can lead patients astray. In a recent case, a patient with rectal cancer was convinced by influencers to pursue unproven treatments like ivermectin or adopt a sugar-free diet, disregarding established medical recommendations. Unfortunately, despite Dr. Yurkiewicz’s efforts to correct her misconceptions, the patient ultimately succumbed to her illness.

Doctors pointed out that discerning trustworthy podcasts can be quite challenging for patients. Some hosts use vague titles like “holistic practitioner,” masking their lack of formal medical training. Others may hold degrees but stray far from their area of expertise, which undermines their credibility.

Additionally, some podcasts breed distrust in established medical practices, framing the “medical industrial complex” as a barrier to discovering supposedly hidden remedies.

Dealing with patients who have firmly held beliefs can be difficult, especially when they dictate treatment paths or judge the medical professionals themselves. Doctors expressed their frustrations over having to counter harmful or costly ideas stemming from podcasts. While they don’t always succeed, they sometimes manage to change patients’ minds.

Dr. Yurkiewicz recently met a patient who began hormone therapy after hearing on a podcast that it could alleviate menopause symptoms. Although hormone therapy can be beneficial, this particular patient had a history of breast cancer, leading Dr. Yurkiewicz to worry about the potential risks involved.

In their discussion, Dr. Yurkiewicz sought to understand what benefits the patient felt she was gaining and talked about the accompanying risks and alternatives. The patient remained unconvinced at that moment but upon reflection, during a follow-up visit, decided it wasn’t worth the potential danger.

Some doctors indicated that their views on podcasts have shifted as they’ve engaged with patients discussing them more frequently.

Dr. Gopal recently listened to discussions on men’s health and hormones through podcasts and subsequently reviewed pertinent studies. While he still holds reservations about testosterone testing being beneficial in many cases, he can now engage in informed conversations about the evidence when male patients ask about it.