In November of 2007, Dr. ScottHaig came under fire for his articlethat appeared in Time Magazine entitled“When the Patient is a Googler.” Inhis article, Dr. Haig describes a patientwho has obviously done her homework,perhaps a little too vigorously,on her knee condition. After listeningto her “diatribe” about her condition,this physician opted to refer the patientto another colleague.
Dr. Haig’s description of this patient and her use of the informationhighway prompted much discussion, even garnering amention in the New York Times. Those who disagreed with theway Dr. Haig handled the patient assumed he was put off by thewoman’s vast amount of knowledge and research, and advocatedher right to inform herself about her condition. Others argue thatthe doctor was put off by the woman’s rudeness and attitude. Eitherway, one fact remains true: this patient had a wealth of medicalinformation literally at her fingertips.
In today’s high–tech world, people are going to electronicallyresearch their medical concerns. If someone wants to know if achild’s rash is chicken pox, all they have to do is Google it and theywill get not only a detailed description of the symptoms but also aphoto to compare the rash with the one spreading across the child.Googling seems to be more common among people with chronicillnesses but even a sufferer of the common cold will turn to theWorld Wide Web to determine whether or not that cough mayturn into pneumonia. Unfortunately, without any training in themedical field, it is often impossible to determine which sites arebased in sound medicine and which ones are merely blogs or anecdotalscenarios, and that is where the problem begins.
But like it or not, “medical Googling” is not a phenomenon thatis going away any time soon and it is a fact that doctors are going tohave to deal with tactfully in order to avoid complaints and/or litigation.Patients are going into their physicians’ offices armed withinformation—some of it legitimate, some not—and asking for specifictreatments and medications. For doctors who are bombardedevery day with new information, paperwork and patients, chasingevery avenue offered on the Internet simply isn’t possible. Doctors,as experts in the medical field, must know what to ignore. But theone thing they absolutely cannot afford to ignore is the patient. Sohow can a doctor validate a patient’s concerns while at the sametime avoid spending hours researching an unlikely Internet cure?
The answer is this: establish a two–way trust.
At the onset of the doctor/patient relationship, the doctormust clearly establish and outline expectations: both what the doctorexpects from the patient and what the patient can expect fromthe health care provider. It must be a two–way street: the patientmust trust that the doctor is the expert and will give reliable andaccurate information and the doctor must be able to trust that thepatient will follow the recommended course of treatment and trusthim or her as the expert in the field.
One way the health care provider can establish that trust is bynot ignoring the patient’s concerns or belittling the patient formaking the effort to research his or her condition. On the contrary,the physician cannot afford to be blind to the fact that patients areGoogling and he or she should make a point to stay abreast of allthe reputable and science–based medical Web sites and recommendthose sites to the patient when applicable. By including thepatient in the process and directing them to sites that may be helpful,the doctor is allowing the patient to feel a sense of control overthe disease or condition, which is often all that the patient needs tofeel secure in the doctor/patient relationship.
Each and every time a doctor prescribes a drug, course of treatmentor other medical care it is always done after a risk/benefitanalysis and there are many things that must be considered includingthe patient’s medical history, drug interaction etc. Doctors usewhat they know and, if they are unfamiliar with potential risks andside effects, it is their responsibility to err on the side of caution.
While there is nothing wrong with patients taking advantage ofthe resources that technology affords, it is imperative that patientsrealize that doctors spend many years being trained and educatedin their chosen fields. Furthermore the patient must trust that thephysician is acting in his or her best interest. By being proactivein establishing that trust and by discussing and recommending appropriateWeb sites, doctors can avoid potentially damaging situations.If, after the physician has made every effort to define theexpectations, the patient still refuses to respect and follow the doctor’srecommended course of care, it may be in the doctor’s bestinterest to follow Dr. Haig’s advice and recommend another physician.
