Manage malpractice risks with self-diagnosed patients

Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even more complicated when patients order drugs directly over the Web.

The debate among physicians about the credibility of online information is as old as the Internet itself. As a caregiver, it’s safe to assume that patients will come into the office already attached to a perceived diagnosis and possibly using medications improperly, based on their own online research.

Consider the following example: A 25 year-old patient experiences a sore throat and slight fever that persists for several days. The patient decides to visit a common Web site known for its medical information. The patient self-diagnoses himself with a bacterial infection and attempts to self-treat by taking expired medication left over from a previous staph infection.

While health care is not “do-it-yourself,” an informed patient can be an asset. A poorly informed patient, on the other hand, clearly complicates treatment. Assume the responsibility of being the primary information source and educator for your patient. To help deal with a self-diagnosing patient, consider the following:

  • Encourage your patient to always check with you about the accuracy of information obtained from external sources. Use the intake time to find out what Internet information the patient has found.
  • Directly discuss what the patient has read, even if the patient’s external source is a good one in your professional opinion, The exchange enhances your relationship with the patient and can increase treatment compliance. Welcome questions, and help put the patient’s information in the appropriate context.
  • Provide your patient with a list of Web sites that provide accurate information, such as the Centers for Disease Control and Prevention ( Make sure the patient understands the limitations of the Internet.
  • Document in the patient’s chart your diagnosis, your treatment management plan, and medication prescribed, as well as the reasons behind your decisions.

David Troxel is Chief Medical Officer of The Doctors Company.

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  • Melissa Gastorf

    I think that the self diagnosed by the internet goes both ways, sometimes good information, sometimes bad.  Minor things like thinking they have a bacterial infection in their throat, not too big of an issue.  Usually results in a discussion and proper usage of antibiotics.  It is the weird and obscure diseases that make things more difficult.  I have had patients sure they had rickets, and despite a full discussion as to how she really didn’t have the symptoms nothing would satisfy her until I ordered xrays and a vitamin D level to start.  It is funny how they never want to believe that their fatigue could possibly be the result of them only sleeping 2 hours a night for the last month, but instead they are in the early stages of MS.  

    I know try to make sure that I arm patients with good websites rather than just googling symptoms.  They are going to do it anyways, so I would rather them use credible websites.

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