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 (www.cdc.gov). 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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