Handout based medicine needs to change

This will be a short post against what I call “handout based medicine”. What’s that? You say…

Let me explain. If you’re a chronic illness patient, you’ve likely had this experience:

You get sent to a new medical provider. Say a nutritionist or a sleep therapist. You go to the appointment. Pay the copay. In the appointment the provider takes a basic history and then says they’ll educate you about this topic & they give you a handout with some basic info. You may ask some questions about this info but it is rarely tailored to you. Then you’re expected to go off & follow this advice & come back to follow up with them.

I’ve had some version of this happen to me many times over the course of various health issues. And it’s a waste of my time and money. I could’ve easily found the handouts online myself & saved myself a trip to an appointment & paying some sort of copay.

Now I realize I’m a bit of a nerdy patient though most chronic illness patients I know are pretty good at finding accurate info online themselves or through patient communities.

It’s also not just that the info is easy to find it’s the fact that it’s generic. Whether it’s nutrition handouts for diets that don’t take into account cultural factors or it’s “sleep hygiene” handouts that don’t take into account chronic illness symptoms, the advice is often useless or impossible to implement. Further if you don’t follow the advice you can get labeled as a “non compliant” patient or a patient who isn’t “motivated” to take care of themselves. [more in another post about why patient motivation as a concept is absurd].

I do recognize that there are patients that do need more basic guidance & there are also cases where the handouts are difficult to find online because they’re proprietary etc. This is often the case for psychotherapy handouts. In those cases I think the solution is to make them easier to find online or for the primary care providers to give them out. Making patients attend another appointment & spend more money on “healthcare” that isn’t actually tailored to their needs is not ok. In short, handout based medicine needs to change.