Should doctors Google their patients?

It’s well known that patients Google their doctors, a practice that’s performed with increasing frequency.

But what about doctors researching their patients on the web?

It’s an interesting idea that I hadn’t thought of. I have never Googled a patient, and can’t see any reason to in a primary care setting. But the context of the piece, which I first saw in the WSJ Health Blog, was in psychiatry. It would be helpful for a psychiatrist, for instance, to know if a patient was blogging about suicidal thinking.

Or in the emergency room, when a patient arrives unconscious with minimal identifying information.

But in routine cases, there are few reasons to do so. Authors of a cited essay agree, suggesting that “doctors ask themselves honestly about their intent in conducting the search and whether the outcome might compromise the trust and relationship between the doctor and patient.”

They even go as far as suggest asking patients for their consent before Googling them. That’s questionable, since we’re talking about information that’s publicly available.

There are few ethical guidelines on this, with opinions on both ends of the spectrum: “Some people say absolutely it should never be done; it’s a breach of privacy … But then many say it should be done as a matter of routine. It’s information that is in the public domain, and it may be information that is clinically relevant.”

The overriding question should be, “Will researching my patient online improve their care?” If the answer is “yes,” only then, perhaps, will there be a legitimate reason to do so.

Should doctors Google their patients?Kevin Pho is an internal medicine physician and co-author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. He is on the editorial board of contributors, USA Today, and is founder and editor, KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • Patient X

    If a doctor googled his patient, how would he know he got the right “Mary Smith”. I just googled my unusual name, and surprisingly found out that there are 7 other people with my name, but none of the results related to me. Also, not all people blog or post comments using their real name.

  • Viking

    I’ve done it, and it yielded invaluable info on a sick non-psych patient. Nailed the diagnosis.

  • Vox Rusticus

    If it is public information, then it is by definition not private.

    I have googled some patients. For others, I have checked publicly-available records. Reasons? Mostly to confirm suspicions of behavioral concerns I have had and to get a fuller picture of the person I was dealing with. A lengthy history of criminal court dispositions is something I want to know about, when someone comes to my practice.

    A car dealer does more thorough checking than that.

  • Patient X

    I’m just curious, do you refine your patient searches with the personal information that’s in the patient’s chart, like SS#, DOB, driver lic. #, address, etc. Since docs are allowed unfettered access to these charts, it would be really easy to take this information to aid in your investigation.

  • Greg

    I have used Google Maps’s incredible Street-View feature to see what kind of neighborhood my patients live in. If my patient goes home to boarded windows and broken glass, with a liquor store on every street and gangbangers on every corner, it may tell me a lot about what this person’s daily experience of life is like.

  • Diora

    @Patient X – searching for SSN is extremely STUPID and borderline illegal idea.
    Please, please don’t EVER use SSNs or any information your privacy policy doesn’t allow you to divulge to public for internet searches. Internet searches are NOT PRIVATE. Googling for someone’s SSN is same as telling somebody’s SSN to a third party without consent. So Patient X – you really don’t want your doctor to use your private info like SSN on Google. Here a CEO of an internet security firm on how he could use your search on SSN for evil purposes. Especially since you are probably going to be using names and other things as well. Needless to say that if someone’s identity is stolen and this person finds out you’ve been googling his private info, he or she may just want to sue you. Or if his/her SSN appears on some public website as a result.

    But if you don’t do this and violate your own privac, and just use first name -last name, then you can easily get the wrong person.

    If I google my real name I get some true hits – papers which I co-authored and patents, but I also get a few links that have nothing to do with me: facebook entries (I don’t have one), signature under a political petition that expresses views opposite to mine… So you should really be sure you got the right person and without divulging SSN.

    Again – never type yours or others’ private information on non-secure websites. Google is NOT a secure website.

  • Diora

    “violate your own privac, ” – typo, I meant here “violate your office’ privacy policy”.

  • Patient X

    Diora, I wasn’t suggesting any of the alarming scenarios you warned about in your post. I am a patient, not a medical person. My question was directed to the doctors who thought it would be a great idea to vet their patients on the internet and I asked if they would ever consider using a patient’s personal info as a tool.

    Greg, your idea about searching your patients’ houses through Google maps led me to do a house search of a couple of my doctors. It was easy with Zabasearch, and the online California property tax database. Besides revealing the property tax, house specs, purchase price, mortgage payments etc., the sites also brought up all their other
    real estate holdings. Wow, nothing is sacred if it’s part of the public record.

    But, Google street view didn’t show any gangbangers or liquor stores on my docs’ corners – they both live in the rarefied 90210 zip code. You’re right though, seeing these doctors’ homes did tell a lot about their lives. Curiosity goes both ways.

  • Hugh

    I have seen psych and soc work consultants using web sites that list criminal convictions, but it never occured to me to Google. Another moral hazard is the opportunity to find out if the patient has ever sued a doctor for malpractice — and then to treat/consent them differently! The Urologist in FL who posted a “Go away if you voted for Obama” sign could check to see if any patient or potential patient had donated to a Democratic candidate. This could go on and on.

  • Diora

    @yious – it’s not just that Google can provide valuable information. It’s the fact that anything typed into a search engine such as Google is open. Not only Google has this information, your internet service provider can potentially have this information, the information is NOT encrypted, and as the author of the article I linked to showed, anybody with a little knowledge of programming and malicious intent can capture this information and use it for not-so-nice purposes. Like steal your identity.

    As to ethical – don’t think about it as looking up your information but as sharing your private information with a third party without your permission. What kind of information the doctor is legally allowed to tell to a third party lilke Google, doctor’s internet service provider as well as whoever is motivated to steal it? The answer to this question shall tell you not only if it’s ethical or not but also if it’s legal or not. Does doctor-patient confidentiality allows a doctor to share your information with others? Are Google employees an exception?

    From this perspective, I think googling on first/last name is OK and then maybe checking information in the search results with what doctor knows about the patient to make sure he/she got the right person. But entering name and address together into a search engine is already telling someone where you live. Now, if you are in a phone book you may not care but what if you are unlisted? How about your date of birth and your name?

    From this perspective I think typing in somebody’s sensitive information into a public search engine is more than unethical. It’s a violation of doctor-patient confidentiality because the act of typing this information into a search engine shares your private information with at best Google, and at worst – the world.

    @Patient X – if your purpose was to ask question rather than make a suggestion than it was actually a good question. I want to know if they do it too because if any doctor types my SSN into a search engine, I’ll complain to the board for violating doctor patient confidentiality. I thought you were suggesting that doctors do it, and this is really wrong.

    But in a sense I am glad that you asked this question. I think there are many people out there who don’t think about typing a sentence into a search engine as about sharing somebody’s information as much as about looking up information.

  • Yious

    I know that Google can provide valuable information on clients. In my business, I have done it

    But I do wonder whether googling certain private information is ethical or not OR maybe ethics isnt the right word…but it just seems a little too much for me if certain parts of my information was used in google