INTERVIEW WITH NATHAN MERRIMAN, MD

Have you ever been a patient, and if so, what did it teach you?

I have been a patient multiple times in my life. My most memorable experience as a patient was when I was a second year Internal Medicine resident, and I became a patient acutely with a progressively worsening headache. It started on my Emergency Medicine shift as a headache with nausea that I thought would go away over the course of the shift. I was wrong. As the headache and nausea worsened, I found it difficult to focus and did not think that was fair to patients or my team members in the Emergency Department, so I took a cab home. Once I made it home, I became quite sick and eventually passed out on the bathroom floor. I remember crawling back into bed to wake up several hours later with a splitting headache that continued. My wife took me to the Emergency Room around the corner from us where I told the ED team that I had the worst headache of my life, knowing that would likely result in at least a CT scan of my head and further work up. When the ED physician came into the room to go over the results of the CT scan with me and my wife, I remember him saying my CT scan was abnormal and I had acute hydrocephalus with apparent blockage of the flow of fluid around my brain. The series of subsequent events that thankfully resulted in a great outcome for me with an urgent brain surgery to remove the small cyst that had blocked the flow of fluid changed my perspective on healthcare as a physician patient and more specifically as a human being who was vulnerable and in need of care. Moving forward from this experience, I believe we are all patients. Each of us has been, is currently, or will be a patient in our lives and what we do today for our health impacts how we feel tomorrow.

“As we earn trust, our patient teammates will share details with us that can help us give accurate advice. If patients don’t trust us to share vulnerable details that impact their health and care plans, then we will not be able to be effective clinical teammates for our patients.”

What are the most important qualities for a doctor to have?

Doctors need to have excellent listening and communication skills with our patients and their family members. We also need compassion with every patient, which I see as empathy with action, and we need to be able to listen for and see the vulnerable moments of our patients because those are some of the most memorable and most important moments that patients will carry forward after each healthcare visit.

What is the most important factor in the doctor/patient relationship and why?

Trust. Trust is the heart of healthcare and as clinicians, each of us needs to continue to work on earning trust with our patients through relationship centered care. As we earn trust, our patient teammates will share details with us that can help us give accurate advice. If patients don’t trust us to share vulnerable details that impact their health and care plans, then we will not be able to be effective clinical teammates for our patients.

What guided your decision to go into medicine and specifically, your chosen field?

In retrospect, I have realized my path in medicine was not a straight line. I remember my initial interest in medicine and healthcare starting after my parents died when I was 13. I had a strong interest in someday working with kids and helping them through traumatic life experiences, so I thought being a child psychologist or psychiatrist would be the best fit for me. As I entered psychology classes and pre-med in college, my interests began to shift. I was able to work with some incredible early mentors in Infectious Diseases in Rhode Island in the 1990s, and I saw the inspiring compassion my physician mentors showed as they helped patients cope with having HIV and AIDS. I also learned early that understanding the different reality based influences, including social determinants of health, in each patient’s life was critically important to helping each patient co-design their treatment plans. Heading into medical school with these foundational experiences in Infectious Diseases, my medical interests evolved further as I encountered the diversity of cognitive and procedural experiences in Hepatology and Gastroenterology in my 3rd year clinical rotations. I eventually found that Gastroenterology with colonoscopy procedures that enable us to prevent colon cancer through the removal of precancerous polyps appealed to me the most, especially in combination with general Gastroenterology and Hepatology evaluations and treatment plan designs with patients.

“Each of us has been, is currently, or will be a patient in our lives and what we do today for our health impacts how we feel tomorrow.”

You recently joined the Doctorpedia team as a Founding Medical Partner. What about Doctorpedia resonates with your personal and professional mission?

I have found it very helpful for patients to do research and take notes about their symptoms and medical concerns prior to visiting with me in the office or for a procedure, but I realized that many patients would benefit from advice about which websites to focus on and which ones to avoid. I thought of the concept that all of us as patients need to Google responsibly in healthcare. Several years ago I started working with patients on differentiating which healthcare websites were high yield with accurate medical information and which sites were questionable with inaccurate information or medical recommendations that had not been adequately studied. Doctorpedia helps patients to have a teammate in online research into their symptoms and medical conditions because all of the Doctorpedia content is reviewed, curated, or created by physicians to help patients have access to accurate medical information.

What problems do physicians face that Doctorpedia can help solve?

The misinformation and at times dangerous information online can confuse and mislead patients, and this can create more stress for patients prior to and during the initial visit with their physician team members. Some of the online advice can also lead to delays in needed patient care. Doctorpedia can help patients to have a trusted online medical information resource, can help patients focus their questions and concerns, and can help inform patients about when they need to seek further medical treatment and advice.

“Doctorpedia helps patients to have a teammate in online research into their symptoms and medical conditions because all of the Doctorpedia content is reviewed, curated, or created by physicians to help patients have access to accurate medical information.”

What problems do patients face that Doctorpedia can help solve?

The internet has a massive amount of medical information and medical misinformation. Patients need a core list of online resources to turn to in order to find accurate medical information, and Doctorpedia can help as one of those trusted, patient-centered online medical information resources. Doctorpedia can also help patients to construct their questions and ideas that they would like to bring up with their physician team members before they go to their clinical care visits.

What is your favorite activity outside of work?

I love writing. I started writing after my parents died and used writing to think about and work through complex challenges. Writing has consistently given me a space to reflect, learn, and grow.

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