Once upon a time, whenever the good citizens of Belgium experienced puzzling symptoms (let’s say, “twitching eyelids”), they would turn to Dr. Google to find out what might be causing the symptoms. But the Belgian government, concerned about false and scary health information online, came up with a public awareness campaign that warned: “Don’t Google It. Check a reliable source!” This also included a referral link to a government health site that could help to correctly answer questions about twitching eyelids and several other health issues.
But many physicians were genuinely concerned that patients could become confused by the incorrect or poorly explained health information they learn online, or that this confusing information might undermine the doctor-patient relationship if their patients follow Dr. Google’s advice instead of that offered by trained medical professionals. You can see for yourself how the lives of Belgian patients were ruined because they searched online, according to this 1-minute “Don’t Google It” TV ad:
The main issue in this dreadful campaign, as I saw it, was not just the implicit assumption that all patients in Belgium are stupid, but worse, it was the utter failure of Belgian bureaucrats to acknowledge that people are ALREADY online! You simply cannot un-ring that bell. . .
Like me, many Belgians are busy Googling all kinds of things, every day, day in and day out.
Personally, I wouldn’t even buy a toaster without checking with Google first to learn as much as I could about useful things like reliability, product features or where to get the best value. And if my first stop is an online search for relatively minor things like toasters, you can be absolutely sure that I’m going to ask Dr. Google about truly important things like troubling symptoms.
And I’m not alone. It turns out that many physicians like to visit Wikipedia when they need information quickly. According to the IMS report called Engaging Patients Through Social Media,
“Wikipedia is the leading single source of healthcare information for patients and healthcare professionals…[and] nearly 50% of U.S. physicians who go online for professional purposes use Wikipedia for information, especially on specific conditions.”
Meanwhile, recent research suggests that consulting Dr. Google about one’s health concerns is not only a pervasively common practice, but may actually have “a positive impact on the doctor-patient relationship.”
An Australian study, for example, found that over one-third of adult patients searched the internet for information on their health problem at some point before coming to the Emergency department (that statistic increases to 60% in 18-29 year olds). Both of those stats, by the way, seem shockingly low to me.
Of those who did seek Dr. Google’s opinion(1):
- 62% searched more than 24 hours before showing up in Emergency
- about 20% did so during the 1 to 24-hour period before arriving
- 12% Googled while already sitting in the Emergency department waiting to be seen
- most people did multiple searches (68% asked about symptoms, 51% about treatments, 41% diagnosis, and 23% choice of health centre)\
These queries make perfect sense. Wouldn’t you want to know all you could learn if you were wondering what the heck was going on in your own body? And this is critically important if you or a family member live with a rare disease diagnosis.
But researchers wondered if seeking these medical answers online would ultimately improve or detract from real life medical care. Dr. Anthony Cocco and his team concluded:
“Searching had a positive impact on the doctor–patient interaction in most cases, and was unlikely to cause patients to question the diagnosis or advice of their treating doctor. Online health information was unlikely to cause patients to doubt the diagnosis by a practitioner or to affect adherence to treatment. ”
He added that the majority of patients said their online searches had helped them to answer a doctor’s questions, and over 90% did not change any of their treatment plans because of conflicting online information they had found.
The researchers recommended that “doctors should acknowledge and be prepared to discuss these online searches for health information with adult emergency department patients.”
Outside of the Emergency medicine setting, other researchers in 2017 warned:(2)
“As patients have better access to health information through the internet and expect to be more engaged in health decision-making, traditional models of the patient-provider relationship and communication strategies must be revisited to adapt to this changing demographic.”
The 2017 study explained that physicians currently tend to respond to their patients’ search for internet-derived health information in one of three ways:
- by reacting defensively and asserting their expert opinion
- by collaborating with the patient to analyze the information
- by guiding the patient to reliable health information websites
That last bullet point is the one I like to mention whenever I speak to an audience of physicians.
“Guide the patient to reliable health information websites.”
Doctors, you know that your patients are already online, so please do not tell them NOT to go there.
Instead, create a prescription pad-like list of credible, jargon-free websites/books with basic health information that you would feel comfortable recommending. Share this list of approved resources with your patients.* For example, Mayo Clinic and Up-To-Date and the Heart and Stroke Foundation are some good sites to start with for heart patients. Even a person who is not experienced in internet searching can quickly learn how to bookmark and navigate these patient-friendly sites.
Stress to your patients that they must become savvy consumers when it comes to online health information, and must learn the difference between truth and trash out there.
And most importantly, please don’t abdicate your traditional role as educator. If you do that, if you don’t steer your patients to curated resources that could add to accurately informed discussions about their health, then the Gwynneth Paltrows of the world will take over that job for you.
Sadly, some of the poorest-quality medical resources are run by those with the letters MD after their names (Dr. Oz and his embarrassingly cringe-worthy “miracle fat-busting cures” come to mind here). In fact, when a study published in the British Medical Journal (BMJ) evaluated how reliable this celebrity doc’s medical opinions were, scientists concluded:(3)
“Approximately half of the recommendations have either NO EVIDENCE or are contradicted by the best available evidence.”
(Oz fans, remember that fact when confronted with his preposterous clickbait TV headlines like: “Seven Libido-Boosting Super Foods That Can Save Your Marriage!”)
What I now recommend to my Heart Sisters blog readers, to the women in my Heart-Smart Women audiences and especially to all those who are living with heart disease, is that their only job is to become the world expert in their own medical diagnoses. As one of my readers said to her cardiologist:
“This is your career, but it’s my life.”
If only the Emergency physician who misdiagnosed me with acid reflux in mid-heart attack had decided to to do a Google search before sending me home. . .
There’s likely only one possible correct diagnosis that he and Dr. Google would have come up with together if the words central chest pain, nausea, sweating, pain radiating down the left arm had been typed into a Google search – and it ain’t acid reflux.
1. Anthony M Cocco et al. “Dr Google in the ED: searching for online health information by adult emergency department patients.” Med J Aust 2018; 209 (8): 342-347.
2. Tan SSL et al, “Internet health information seeking and the patient-physician relationship: a systematic review.” J Med Internet Res 2017; 19: e9.
3. Christina Televised medical talk shows—what they recommend and the evidence to support their recommendations: a prospective observational study.” “
* In my book, “A Woman’s Guide to Living with Heart Disease“ (Johns Hopkins University Press, 2017), I included two full pages listing helpful books and websites of interest to heart patients (under Recommended Resources). You can ask for this book at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (use the code HTWN to save 20% off the list price when you order).
Q: Have you Googled your own symptoms before deciding what to do?
- A second opinion from Dr. Google
- Doctors who aren’t afraid of “Medical Googlers”
- When you know more than your doctors about your diagnosis
- When you fear being labelled a “difficult” patient
- Reliable health info from the ‘medically unqualified’
- What doctors really think about women who are ‘Medical Googlers’
- Health information online: how to tell the trash from the truth
- For more on why you should stop watching Dr. Oz, read this interesting Vox piece by Julia Belluz called “Why Dr. Oz Can Say Anything and Keep His Medical License“