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How Online Medical Info Impacts Patient-Provider Relationships

Ninety-seven percent of providers said online medical information leads to misinformed patients, impacting the patient-provider relationship.

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Source: Thinkstock

By Sara Heath

- The slew of online medical information is impacting patient-provider relationships, according to a new survey from Merck Manuals.

The survey of 240 family physicians found that patients are increasingly accessing online medical information and self-diagnosing using that information.

This is resulting in increased patient-provider interactions, respondents said. Eighty-two percent of physicians said they have noticed increased patient phone calls to nurses’ lines as a result of medical information access.

Sixty percent of providers said they have noticed more patients coming into the office with medical inquiries informed by online research. Patients are doing online symptom searches, finding a diagnosis, and then seeking out medical help with the information they have gained, the researchers explained.

This is not the case for all doctors, however. While most doctors have observed patients seeking out “Dr. Google” at increasing rates, some say online medical research is keeping the patient out of the doctor’s office. Twenty-nine percent of physician respondents said that patients are visiting the clinic less frequently because they are self-diagnosing and do not deem a doctor’s visit necessary.

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While this may seem like an attractive way for providers to reduce patient volume and cut healthcare costs, industry experts must be wary of the sources patients are seeking. A patient’s own self-diagnosis is only effective if she is consulting reputable sources.

And patients aren’t always connecting with that credible research, the survey authors continued. Ninety-seven percent of respondents said their patients are coming into the office with incorrect information.

“It’s a double-edged sword for patients and providers,” Robert S. Porter, MD, Editor-in-Chief of The Merck Manuals, said in a statement. “As patients seek answers to their questions online, it’s all too easy to be misled by sources that are not medically correct. That can have a significant impact on how patients approach appointments and what they expect from interactions with their physicians.”

For example, nearly 80 percent of respondents said online information has increased the likelihood that patients question their diagnoses or treatments.

“In some ways, it's made appointments more complicated,” said Timothy, a physician respondent from Alaska. “Patients search their symptoms online and see the worst-case scenarios, rather than the most common scenarios, so they come into appointments with more anxiety.”

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Healthcare professionals have little power over what information is published online, nor over whether their patients access that information. Instead, it is essential for providers to drive patient education about what online resources are credible and when the patient should defer to a physician.

“We run into problems when patients go to online sources that aren't evidence-based medicine,” said Khyati, a physician respondent from Dixon, Illinois. “But patients aren't going to stop looking up their symptoms on the Internet, so it's up to physicians to direct them to trusted sources.”

After all, online medical resources have been a boon for physicians, too. Eighty-three percent of providers said they use online medical websites to help explain medical concepts to patients. Eighty-nine percent said having access to online resources makes them feel more confident when diagnosing and delivering patient education in the exam room.

Reviewing the types of online resources providers access themselves may be a good place to start. When a provider uses a website to reinforce patient education, that provider should explain why the website is reputable and could be good for future patient use.

Additionally, providers can empower patients with the skills to determine reputable websites themselves. Merck recommends using the STANDS technique with patients:

  • Source: Does the resource cite recognized authorities and provide their credentials?
  • Transparency: Is it open and obvious whether the site’s mission is educational or commercial?
  • Accessibility: Is the site available without registration, and is there a way for users to contact someone with questions or concerns?
  • Neutrality: Is the information available purely as a resource, or does the site benefit financially from what its users do (such as buying products or visiting advertised websites)?
  • Documentation: Is the site updated when needed by recognized medical experts?
  • Security: Can users access content without forfeiting personal information?

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“Our survey uncovered an interesting dynamic at play. While the ease and availability of online medical information instills confidence in family physicians, they believe ‘Dr. Google’ has the potential to introduce anxiety among patients,” Porter said. “The disconnect here is credibility. When reviewing medical information online, physicians can exercise a high level of discretion based on their training. It's more challenging for patients to identify medically correct sources.”

The rise in patients accessing online medical information is likely due to two key trends.

First, more websites are hosting this kind of information, making it easier for patients to access medical information and make a self-diagnosis.

Second, value-based care models are pushing for more patient engagement. As providers empower patients as the drivers of their own health and wellness, patients are seeking out more medical information.

Research indicates that patients largely understand the need for credibility when accessing an informative website. A 2017 study published in the Journal of Medical Internet Research revealed that patients mostly consider usability, simplicity, and source authority when looking at online medical information.

When content is easy-to-understand and navigable for patients, they are more likely to trust the website. Patients tended not to trust websites that required them to wade through troughs of disorganized information.

Additionally, being able to identify the author or presiding organization made websites more trustworthy for patient information seekers. Websites that offered contact information for the author or identified website owners and third-party contributors were perceived as more credible than those that did not.

The researchers found obvious advertising on the websites was an undesirable feature and did not instill site credibility. However, little other research was identified about the factors leading to negative patient perceptions of health information websites.

Although patients seem to be on the right track discerning credible medical sources themselves, it will still be essential for providers to check in with their patients. Providers should ask whether their patients read online medical resources, which sources they look at, and for which purposes. This will allow providers to vet these sources and direct patients to websites that are more credible.

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