How do you relate to their use of the Internet?
Patients need to feel proud that they have looked something up. I don’t want them to feel that this is a ‘dirty little secret’ that can’t be shared with their provider. I encourage patients to be invested in their care, and that educating themselves about their condition is part of that process. I stress that their care is a partnership between themselves and me.
How do you bring up the question of their Internet use if they don’t broach the subject to you?
I have some colleagues who ask proactively about whether their patient has researched his or her condition online. I generally don’t do that. Instead, when I ask patients about their presenting complaint and what is going on for them, I am reading their body language, not only what they are saying or asking. If I sense that there is something unsaid, I begin asking what other concerns they might have. My line of questioning may then lead to their saying they “read” or “heard” such-and-such, and further questioning reveals that they have found information online that concerns them or may be at odds with what I am recommending or that they may want tests or procedures that I haven’t brought up.
How do you respond when a patients acknowledges using the Internet to prepare for or inform the consultation?
First of all, I ask where on the Internet the patient has obtained the information. Was it a Website and, if so, which one? Was it on Facebook or a blog? Some people have done a Google search and don’t even remember which site they got their information from.
I always say that I would be happy to read what they have been reading, and then we can discuss it. Depending on the source, I might express concern about its reliability and then suggest more reputable sources. (Table)
I also encourage patients to look up questions about their health conditions on these reputable sources. This encourages them to be invested in their care. Additionally, it is a form of self-care. Where I practice in Washington DC, the traffic is awful. A patient may sit in traffic for over two hours just to have a fifteen-minute appointment. So I say, “You may not have to see me if you can obtain the information online.”
But there are some caveats I emphasize. If you’re concerned that you might need to go to the emergency department, then you should go immediately rather than sitting and reading the Internet. But if it’s 3:00 AM, I have no problem with looking at the Internet to check what typical symptoms of a heart attack are. But if they have symptoms, I tell them not to sit looking up whether they need to go but to get there as quickly as they can.
Do you have any additional thoughts?
I think the Internet is here to stay and will continue to become more heavily used, especially as social media platforms proliferate. Physicians should stay aware of these sources of information, engage with patients in conversations about them, and be familiar with reliable resources to recommend.
Reliable Resources for Patients
|American Academy of Family Physicians (AAFP)|
- Tan SS, Goonawardene N. Internet health information seeking and the patient-physician relationship: a systematic review. J Med Internet Res. 2017;19(1):e9. Published 2017 Jan 19. doi:10.2196/jmir.5729
- Pew Research Center. About three-in-ten U.S. adults say they are ‘almost constantly’ online. https://www.pewresearch.org/fact-tank/2019/07/25/americans-going-online-almost-constantly/. Accessed July 30, 2019.
- Pew Research Center. Internet/Broadband Fact Sheet. https://www.pewinternet.org/fact-sheet/internet-broadband/. Accessed June 12, 2019.
- Pew Research Center. Health Online 2013. https://www.pewinternet.org/2013/01/15/health-online-2013/. Accessed July 30, 2019.
- Eligibility.com. The Most Googled Medical Symptoms by State. https://eligibility.com/medicare/states-most-googled-medical-symptom. Accessed July 30, 2019.
- Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW. Patients’ use of the Internet for medical information. J Gen Intern Med. 2002;17(3):180–185. doi:10.1046/j.1525-1497.2002.10603.x