Guiding patients online is a new physician responsibility for the digital age

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The following op-ed was published on February 22nd, 2011 in AOL News.

If you woke up one day with an earache, you could call your doctor’s office for help. Or you could do what the majority of patients do today and Google what to do first.

Type “earache” into your Web browser and the results can vary wildly. Search engines can return results saying that an earache can be from the common cold, needing nothing more than over-the-counter remedies. Or it could be a sign of a brain abscess, which requires emergency medical attention.

Only 7 percent of doctors e-mail their patients, let alone engage them on blogs, Twitter or Facebook. A recent international health survey conducted by the London School of Economics found that only one in four checked the reliability of online health advice. When you consider that nearly two-thirds of patients are consulting the Internet for their medical symptom or condition, that’s a lot of patients accepting what they read on the Internet at face value.

That can be dangerous. If a patient wanted to learn CPR, for instance, a typical Web search would lead to one of more than 50 such instructional videos on YouTube. But according to a recent study from the Medical College of Wisconsin, more than half of those showed improper technique; either the rate or depth of chest compressions was wrong. Worse, just a handful reflected the American Heart Association’s 2010 resuscitation guidelines update, which now advocates “hands only” CPR, without mouth-to-mouth breathing.

Patients not only are looking for health information on Google, but also on social networks like Facebook. These sites are popular with patients who, according to the Pew Internet and American Life Project, generally gravitate toward user-generated information. It’s no wonder that 22 percent of all online time is typically spent on a blog or social network, with patients reading other people’s commentaries or experiences with a particular test or treatment. But can these communities substitute for a qualified health professional?

A study last year from Harvard Medical School, which looked at 15 of the largest Facebook diabetes communities and analyzed close to 700 “wall” posts, gave some insight. Most of the comments provided support among diabetics and included strategy tips, personal advice and emotional outreach. But more than a quarter of posts were promotional in nature, advertising non-FDA approved products of questionable efficacy or safety. So although social networks have definite value in connecting patients, the information needs to be viewed with a critical eye.

With only 7 percent of doctors e-mailing their patients, let alone engaging them on blogs, Twitter or Facebook, the medical establishment needs to realize the influence of the Internet and social media on patients.

Guiding patients to better online sources of medical information should be a new physician responsibility for the digital age. Not only should doctors expect and be receptive to questions patients raise from Web research, they need to proactively engage patients online in order to dispel falsehoods and guide them to legitimate sites.

Until then, patients should be vigilant about checking the source of what they read on the Web. Ensure it comes from a reputable institution — such as a hospital, medical school or government agency.

The Internet has fundamentally changed the doctor-patient relationship by breaking down the information walls traditionally separating patients from their health professionals. How both parties navigate this new paradigm will determine how much the Web and social networks will benefit patients.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today. He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.