Tuesday, February 17, 2015

Doctors, please do not Google your patients

An article by Randi Belisomo in Scientific American plays off another one in the Journal of General Internal Medicine, both asking the question:

Is It OK for Doctors to "Google" Patients?

The authors write:

 . . . that sometimes, the practice is acceptable. Most other times, in their opinion, it isn't. They hope their paper sparks conversation among colleagues and the American Medical Association about the possibility of guidelines for providers in the digital age, one in which most medical students can't remember a world without search engines.

Well, here's my take, short and sweet.

First, the likelihood that an MD is going to find something clinically relevant about a patient on the Internet is infinitesimally small.  Why? Well first of all, there is no guarantee--none whatsoever--that whatever you ready about a patient is accurate.  That should be obvious anyone who has searched the web for anything, but it especially applies if an article was written by someone other than the patient.  Recognize, too, that the Google search algorithm does not include everything that is written on the web about a person: It tends to present the most viewed articles.  Those might simply be about the most controversial aspect of that person's life, not necessarily the clinically relevant aspects.

Even if it an article was written by the patient, though--even in the last hour--it was prepared for a public audience.  This is a very different portrayal of personal information than would be communicated in the privacy of the exam room.

Second, the likelihood that you are going to be inadvertently diagnostically anchored by what you read is very high.  Studies show over and over again that even skeptical readers are highly influenced by what they read.  Diagnostic anchoring is a cognitive error.  Hence, you don't even know it is happening to you.

So, here's my advice, doctor.  If you really have the 5 or 10 minutes available to read about a patient on the web, spend the time instead with the patient.


Perry Horwich said...

From Facebook:

If the googling Doc is logged-in to google when they perform the search, I suspect that the web log history maintained by google might represent PHI and could violate HIPAA.

Elaine Schattner said...

From Facebook:

I'm not so sure, Paul (as much as i do think doctors spend insufficient time w/ patients). In the old days, patients were part of a doctor's "community" and so doctors ~knew the personal histories, but still had to separate truth from rumor, treat them fairly regardless of their baggage. Isn't that the case now?

Pamela Katz Ressler said...

From Facebook:

Interesting perspective, Paul but I'm afraid I don't agree. While implicit or explicit bias may enter by googling a patient, there is also the potential of understanding their narrative a bit more. Each of us enters the healthcare system with our own story and we leave an encounter with the medical system with a diagnosis. The more we learn about the person and not just their symptoms leads to better understanding and ultimately better care. I understand that there is often false or out of context info on the web, but there has always been false and out of context info even in real life encounters. Thanks for a thought provoking post

Anonymous said...

Agreed. I look up info on docs for professional reasons (education background, CV, papers published). Telling me if someone skis doesn't help me know whether they're going to be competent at the job. I wouldn't look up my plumber or electricians' info for any other reason.

Doctors need to spend time doing more UpToDate searches, CME learning, that is going to help patients and their own professional knowledge. Otherwise, they need to spend time with family or their own hobbies. If you have a patient that has the same hobby, fine but can we please keep our relationship professional?