Lancaster Physician Fall 2019 - 23

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hat does picking a restaurant for
dinner, finding the newest fall trends,
and diagnosing a rash have in common? For the average American, the
first step in all three processes is a quick trip
to the internet.  
With the proliferation of the digital age,
many people use the internet to answer questions about health. A 2013 report from the
Pew Research Center found that 35 percent
of Americans had used an online resource
to self-diagnose. The wealth of information
that we have, literally at our fingertips, can
be empowering; however, we need to exercise
caution on how this power is used.
The perils of consulting Doctor Google
are many. The internet is riddled with information from questionable sources. Just like
news, medical information is often obtained
via social media sites such as Facebook,
Twitter, and even Instagram. The first few
results of an online search could lead a person
to vastly different paths and equally diverse
levels of paranoia.  A Google search may
reveal the cause of a headache to be a brain
tumor, stroke, or simple migraine. As a result,
searching online can be frustrating and lead
to the second major problem - anxiety.  
Anxiety about health is not new, but the
scale of information we have today is certainly unprecedented. In fact, the new term
for this phenomenon is cyberchondria, the
unfounded concern over common symptoms
based on online research. Without direction
from professionals, who usually have over a
decade of graduate medical education, the
internet can be a difficult place to wander. 
Physicians must understand how to
approach patients who have consulted Doctor Google. Instead of becoming defensive,
they should embrace the seemingly disruptive technologies and use them to motivate
patients and develop quality-driven care.
When patients present to the clinic with
a diagnosis in hand, it is a window into
the significant gaps in patient-physician
communications that are detrimental to
the relationship. If we understand these
gaps and focus on improving them, rather

than simply highlighting them, we will be
on our way to better health care.
In order to identify and address these gaps,
we need to ask the simple question: Why is
Doctor Google the new MVP? 
CONVENIENCE
As people of the digital age, we turn to
the internet for almost all our problems.
Suppose a patient wakes up with a rash. She
may already be running late for work and
have a million other things to do. Patients
"google" their symptoms to not only figure
out the cause, but also to make sure an
urgent evaluation is not indicated. However,
the intention of saving time may not always
actually save time. A Google image search
of a rash may take a person a lot longer to
filter through than a visit to their doctor.
Before turning to the internet in the late
hours of the night, patients are better off
calling their physician's office. There are
usually on call doctors who can provide
guidance. Also, many outpatient centers
have the option of a "patient portal" which
is an online system to look at their chart and
contact their physician. It may be faster to
send a quick email and speak directly with
a doctor. Physicians and office staff should
make patients aware of these options.
UNDERSTANDING
A 20-minute visit is not always enough
time to understand a disease process. Physicians are fairly well trained at completing
a history and physical within a short visit;
however, it is equally important to counsel
and explain a disease process in that time
frame, as well. Physicians should be willing
to put aside the stethoscopes, grab their
pens, and offer a quick anatomy lesson to
explain complex conditions, such as heart
failure. They can show visuals of different
birth control options or suggest helpful
apps that can be used to count calories.
It is important for physicians to become
familiar with the online resources that are
available and accessible to their patients.
Appropriate resources, such as the Centers
for Disease Control and Prevention, the

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23

PHYSICIAN

American Academy of Family Physicians,
and The National Institutes of Health, can
guide patients to ask the right questions.
 REASSURANCE
Even when a patient knows their diagnosis, they may approach the internet for
reassurance. The family of a pancreatic cancer
patient may understand the disease, but still
needs emotional, financial, and logistical
support. Or, a patient may be fearful and
skeptical of an upcoming knee replacement
surgery. It is important to review the surgery,
but also equally important to discuss why
another cortisone injection or alternate
therapies are not appropriate. Encourage
patients to do research after the diagnosis
is offered and review their findings with
them. Instead of feeling slighted by a third
party in the doctor-patient relationship,
physicians should recognize that by sifting
through online sources, patients are taking
the first steps in controlling their health. If
the patient is motivated to seek out medical
information, they might be motivated to
follow up and comply with treatment plans.  
FINAL THOUGHTS
The journey to a diagnosis is just as
important as the destination. Doctors should
realize that building a diagnosis requires not
only understanding the symptoms, but also
identifying social, economic, and environmental factors that may impact individual
health. Patients should understand that the
internet is just one tool that can be used in
the diagnostic process. 
Patients should use the internet, but
similar to their medications, use it as prescribed. Physicians, rather than discouraging
patients from using the internet for fear of
false information, should take the time to
explain the disease and comfort the patient
along the journey. In the modern era, the
doctor-patient relationship is more like a
love triangle, internet included.



Lancaster Physician Fall 2019

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