In my practice, I see all types of patients.

Some have significant medical knowledge, while others come in as relatively clean slates. Some love to research their symptoms online, while others prefer to simply trust their doctor to guide them. What they all share is a genuine desire to be healthier.

Neither type of patient (or anything in between) is a “problem.” All human beings differ from one another, and it’s my job as a physician to adapt my care to each unique individual.

Of course, different characteristics come with different pros and cons, but awareness of our own tendencies can be helpful in mitigating the cons.

Here I’ll discuss some of the pros and cons associated with medically intelligent patients (“intelligent” here being defined as a high interest in and ability for researching their own symptoms and ailments).

Let’s get into it.

Know Your Expertise: The Importance of Communication

When you consult with any professional, an inherent balance of expertise exists. It’s why you seek them out in the first place. When I need help with retirement planning or buying a home, for instance, I call a financial planner or real estate agent with years of dedicated training and experience in those fields.

Physicians fall into the “expert” category in the medical field. We undergo anywhere from 11 to 18 years of education and training, building up an extensive internal “database” of medical knowledge.

However, you know something better than any doctor: yourself.

There’s a saying in medicine stemming from a study published in 1975: “A careful history will lead to the diagnosis 80% of the time.” In other words, you as the patient know yourself best. You know your symptoms, your patterns, your concerns. If we as physicians listen properly, then we should be able to achieve an accurate diagnosis 80% of the time from that conversation alone.

As physicians, this is our job: listen intently and ask the right questions to draw out more data. Even tone, body language, and subtle nonverbal cues can tell part of the story. (That’s one reason I prefer in-office visits over telehealth. While telehealth has its place, some elements simply don’t transfer virtually.)

Healthcare is a partnership that depends on two-way traffic: the physician’s expertise and the patient’s knowledge of themselves.

When Information Overload Gets in the Way

Today’s patients have unprecedented access to information. Dr. Google and AI programs can provide answers to virtually any health question within seconds. While I genuinely encourage patient research and participation in your own care, this firehose of information lacks something crucial: context.

Knowledge on its own is disconnected from you as an individual. My job as a physician is to take all the personal information you bring me, run it through my internal “database” of medical knowledge, and connect the two. I then give you a response that actually applies to your unique situation. This is personalized healthcare.

In medicine, context is everything. A skilled physician knows how to get the necessary context from a patient to make personalized recommendations.

This is one reason I enjoy practicing in a concierge model of care. In this model, the doctor-patient relationship is primary. The doctor has the time and freedom to hear the patient fully, connect what they hear with their medical knowledge, and provide truly personalized care.

Symptoms vs. Diagnoses

As patients share with me their medical concerns, they may (intentionally or inadvertently) tell me a diagnosis rather than a symptom.

For example, a patient might say, “I have frequent migraines,” versus, “I have frequent headaches.” When patients label something before their doctor has had a chance to evaluate it, they can actually skew the physician’s view and send them down the wrong path.

A migraine is a specific type of headache with particular characteristics. But if I immediately start thinking about migraine protocols, I might overlook other very plausible diagnoses, like cluster headaches, infections, vision strain, and stress-related tension.

The tendency to self-diagnose is much more pronounced when a patient enjoys independent research.

For this reason, my practice is to let patients share their full history with me, and I take notes. When they finish, I use my notes to come back with clarifying questions. “What do you mean by migraine?” “Can you describe exactly what you’re feeling?” This helps me get to the actual symptoms I need to consider.

However, this dynamic has a positive side as well.

As a doctor practicing functional medicine, I’m always looking for the root cause of symptoms and disease. But treating a patient isn’t just about dealing with the root cause. It’s also about addressing the patient’s root concerns.

A patient might seem inordinately worried about their headaches. After a few questions, I discover that beyond the obvious problem of discomfort, they’re actually worried they have a brain tumor.

When I uncover a perceived or feared diagnosis like this, I can respond directly to that concern. I can (most likely) point out all the other factors indicating this isn’t present, which may even help to resolve the symptom itself.

Alternatively, perhaps a chronic pain patient brings up lingering discomfort or impaired ability after a hip replacement. As we converse, I find that they had their own ideas about how they should feel and move after surgery. In this case, I can help by providing realistic expectations. For instance, chronic pain sufferers may not achieve complete pain relief, but they will have significantly improved quality of life.

Understanding and addressing underlying concerns and expectations is just as important as treating a patient’s physical symptoms.

Finding the Right Level of Engagement

Every individual enters my practice with a different level of engagement, and each approach has pros and cons.

I don’t try to change my patients to some imaginary “ideal.” Instead, I identify their interests and aim to work with their unique level of engagement.

The “Clean Slate” Patient

Some patients come in trusting everything I tell them, almost like a clean slate. They have little medical knowledge or interest, and they’re content to trust my recommendations. With these patients, too much information would overwhelm rather than support them.

On the positive side, these patients generally believe what I tell them. On the negative side, they may have lower engagement in their own health. I’m able to tailor their plan accordingly.

The Researcher Patient

Other times, patients come in with extensive research and perhaps multiple self-diagnoses. I don’t want to discourage their curiosity. It indicates high engagement in their own healthcare, which is valuable.

However, if I don’t make a convincing case for my diagnosis or treatment plan, they could leave and go down more rabbit trails on their own. So I encourage them to bring in a written list of their concerns. I then listen and ask questions.

When I share a diagnosis or recommendation for their health, I give them extensive information and even studies to read. This increases their confidence in the diagnosis and plan, which in turn increases their compliance once they’re at home.

The Most Important Advice for Smart, Engaged Patients

For my smart, successful patients who are used to researching and solving complex problems in their own lives, here’s my single most important piece of advice: Remember that your doctor is a repository of enormous knowledge and training.

I sometimes ask people this question: Is it better to work on your strengths or your weaknesses? Most people say weaknesses, but the answer is actually strengths.

If your strength is researching topics until you feel comfortable and informed, that’s wonderful. Bring that to your appointments. But remember this principle I was taught in medical school: We don’t treat lab tests; we treat people.

The data and research you bring matter. But they need to be filtered through the lens of clinical experience and connected to you as an individual. That’s what makes healthcare effective.

Of course, this all requires having a doctor with whom you can converse openly and who listens carefully. If you need help finding one, consider the tips in my post on finding a concierge physician who’s a good fit for you.

The partnership between physician and patient is what makes healthcare work. You can’t substitute that relationship with information from Google, no matter how thorough the research. When we work together, combining your knowledge of yourself with my medical expertise, that’s when we achieve the best outcomes for your health.