As a doctor, I’m always trying to assess where a given patient is along the spectrum of self-tracking readiness. I’ve found that many people fit into one of these three broad categories:
1) “Hardcore quanter.” They know, or think they know, exactly what they want/need, often specific laboratory tests, devices, or ot
her medical things that require a doctor’s prescription. They also have excellent insight into their health/medical situation, and have already researched all available diagnostic and therapeutic options. I see my role as evaluating their health and proposed experiments to make sure I’m participating in something that is safe and potentially effective, and working as a cooperative partner.
2) “Quant-ready.” They understand that the quickest way to figuring out a mysterious health problem, or to optimizing well-being, can be to self-track symptoms and other biometric or laboratory variables over time, thereby gaining better self-understanding. But they need help designing the experiment, figuring out what to track, and implementing the process in the context of their (often busy) life. This can be time-consuming but is often extremely satisfying all around.
3) “Pre-quant.” They still exist in the passive “I go to a doctor so he can figure out what’s wrong with me and fix it.” paradigm. But with education and motivation many of these can be won over to the N-of-1 research paradigm. I continue to work on ways to communicate these concepts creatively, often using techniques from Motivational Interviewing (http://www NULL.motivationalinterview NULL.org/).
4) “Misguided quanter.” A 92-pound adult with an eating disorder who is obsessed with extreme elimination diets and symptom tracking, while ignoring the elephant in the room. A patient with severe obsessive-compulsive disorder whose self-tracking has eclipsed all social relationships. I try to identify these patients and gently steer them toward the help they need.
5) “Googlers.” Not exactly a quanter, but self-diagnose and select their preferred treatments on their own using online search tools. How this works out can vary widely..
Each of these categories brings up an array of questions – how can doctors best engage with a given patient around self-tracking? How can patients find doctors who are open to facilitating a self-tracking approach to health? What resources need to be developed to make these interactions more efficient and helpful?
Paul Abramson MD