How Patients Can Utilize the Internet Before Seeing a Doctor

Today, the internet and social media have truly impacted several industries, one of the biggest being the healthcare industry. A majority of patients are turning to the internet to do research before going to see their doctor. In fact, for over 60% of American adults, the internet serves as a diagnostic tool. Why is this so? Research shows that some individuals are hesitant to spend money on medical consultations, committed to other priorities, or feel embarrassed about their medical conditions.

Some patients choose to Google symptoms through the popular symptom checker on WebMD. There is even an app they can download to their phones to help them understand what their symptoms could mean, learn about potential medical conditions, and make better informed decisions regarding their health. However, the internet can also be tricky this way. Sometimes, a patient will come into your office with a diagnosis in mind and they are not always right. It can be easy to jump to conclusions when it comes to sickness or a disease.

“In the age of WebMD, it’s easy to see why we increasingly view ourselves—and have started to behave—more like doctors-in-training than traditional patients. And this isn’t necessarily a bad thing. Patients with more information about their conditions and treatment options are ultimately more proactive and better patients—but only if they have the right information and only if they use it to engage in a productive dialogue with their doctors,” wrote Theresa MacPhail, an assistant professor in the Science, Technology, and Society Program at Stevens Institute of Technology.

So how can patients use the internet without allowing them to think that they have diagnosed themselves? How should you, as a doctor, approach a patient who is completely sure that they have a diagnosis?

• Inform the patient that Google does not know them personally. During their appointment, let your patient know that there is no way for Google to know their entire medical history – both personal and family history. Nor can Google conduct tests and physical examinations.

• Inform the patient that Google is inaccurate 59% of the time. According to a research study conducted back in 2012, 3000 participants researched a medical condition online and of that particular group, 1,230 participants (a little over 40%) who performed a self-diagnosis online stated that their doctor confirmed their concerns. This percentage is extremely low and it is important to inform each patient that they should not rely so heavily on Dr. Google.

• Inform the patient that the internet enhances cyberchondria. Cyberchondria is the growth of concerns regarding one’s symptoms based on review from online sources and search results. Extensive internet research can cause your patient to become overwhelmed and lead them to think they have a disease when they don't. The more complex their medical problem is, the more likely it is that their self-diagnosis will be incorrect.

• Inform the patient that you understand their efforts in spending time researching their symptoms. Sometimes, it can be helpful to make your patient feel comfortable about their efforts by giving them validation. Moreover, encourage him or her to verbalize their thoughts, feelings, and concerns so that you can identify a potential diagnosis.

“I wasn’t surprised to see that 80% of online diagnosers used a search engine (Google, Bing, etc) first when looking for a diagnosis. We’re impatient and busy–search engines provide rapid responses–no wonder we all start there! Even in the exam room with patients, I often will start with a search engine when a family and I seek to find information. I think the complexity and trick of serving patients well is in the next step, what comes next–AFTER online diagnosers peruse the search engine results–which site you click on next is telling and likely will have lasting effects on the quality of information you find. That’s where we physicians need to be useful—we need to help our patients know where to go for quality, research-based, data-backed advice,” wrote Wendy Sue Swanson, pediatrician.

• Inform the patient of accurate and reliable online sources. Your patient cannot be guaranteed 100% that the information they read on the internet is accurate and you cannot stop them from going online. For this reason, guide them to more reputable sources, such as websites that are associated with healthcare facilities or academic medical centers.

• Inform the patient that the internet increases the risk of confirmation bias. Confirmation bias refers to the tendency to search for evidence to support pre-determined beliefs or opinions. When a patient continuously searches online for evidence to support their pre-determined opinion of their symptoms, the chances are that they will come to you for confirmation. Let him or her know that Google is not always right and that you cannot confirm what isn’t there. Rather than reading about their medical concerns, they should pay attention to your expert advice.

• Inform the patient that the internet increases the risk of anchoring bias. Anchoring bias refers to the tendency to rely on the initial piece of information (the anchor) when making decisions. Your patient can have an anchoring bias if they are determined that they fully understand their symptoms. During their appointment, let him or her know that they should not leave out any important details or information as it can be crucial to their diagnosis.

• Inform the patient that the internet does not listen. Open communication between you and your patients is crucial to getting to the bottom of a diagnosis, recommending an appropriate treatment plan, and improving outcomes. Let your patient know that you do not want to misdiagnose them and that open and honest communication is crucial to their treatment. In other words, let him or her know that regardless of what they decide to do, your treatment plan can work faster than a solution they have read about online.

• Inform the patient that their side of the story matters. When a patient turns to the internet for self-diagnosis, chances are that if they have 4 out of 5 symptoms of a particular medical condition, they will get it in their heads that they have the 5th symptom as well. During their appointment, encourage him or her to give you all of the details. Let them know that you are not interested in the Google diagnosis but rather their side of the story.

Most important of all, you should not let the internet get between you and your patients. You should stress to them the pros and cons associated with self-diagnosis and why it is in their best internet to come in to see you before jumping to conclusions. “The Internet will never replace human interaction. It can’t show you compassion, empathize with you, give you a shoulder to lean on, hold your hand, rejoice with you or grieve with you. Dr. Google will never know you or care as much as I do,” wrote Tracey Delaplain, obstetrician-gynecologist.

In today’s day and age, there is no way to shut off the internet and social media networks; however, there are ways in which you can educate your patients and direct them towards more legitimate websites. When it comes down to it, it is just a matter of open communication and passing along the right information. It is your duty not just to provide accurate clinical assessment and diagnosis but to serve as a patient advocate. “While self-diagnosis threatens medical authority, it’s also associated with better patient compliance and self-care.

Essentially, the character trait that drives someone to seek out medical information is the same one that accelerates a desire to improve and therefore follow a plan of care,” said Dr. Rami Hashish, medical correspondent for Dignity Health located in San Francisco. Although advancements in technology play a vital role in healthcare, they cannot replace the aid of doctors and other healthcare professionals when it comes to receiving an accurate diagnosis.