Dr. Google ONLINE HEALTH INFORMATION AND THE DOCTOR -PATIENT RELATIONSHIP

Transcription

1 Dr. Google ONLINE HEALTH INFORMATION AND THE DOCTOR -PATIENT RELATIONSHIP

2 Bio and COI Matthew Pjecha, MSPP Program Associate Center for Practical Bioethics No conflicts of interest

3 Learning Objectives Describe online-diagnosis and the role of online health information in the doctor-patient relationship. Identify the unintended consequences and ethical dimensions around online-diagnosis and online health information. Employ online health information resources available to patients in a way that supports shared-decision making.

4 What we will talk about What is Online Health Information and Online Diagnosis? What do they look like in The World? What does Online Diagnosis mean for the doctor-patient relationship? What can clinicians do to adapt to Online Diagnosis? What can patients and caregivers do to be responsible consumers of Online Health Information? Q&A

5 What is Online Health Information? Medical information Illness Treatment Health information: How to stay healthy Diet, Exercise, Hygiene Social media: Online communities of patients, caregivers, and providers

6 What is the Problem? Imperfections of both the information s quality and the patients evaluation capabilities support the necessity of a powerful doctor. However, patients unaware of their limited evaluation capabilities may nevertheless behave more powerful in the relationship, causing discrepancies with the doctor. (Christmann 2013)

7 Online Health Information 81% of U.S. adults use the internet. Of those, 72% say they have looked online for health information in the past year. Of those, 59% say they have ever gone online to diagnose a medical condition they or someone else might have. So 35% of U.S. adults are Online Diagnosers. (Pew 2013)

8 Online Diagnosers 41% of Online Diagnosers said their diagnosis was confirmed by the clinician. An additional 2% say it was partially confirmed. 35% said they did not visit a clinician. 18% said a clinician did not agree or offered another opinion. 1% said their conversation with a clinician with inconclusive. (Pew 2013)

9 Online Diagnosers Online health information is here to stay and online diagnosis is likely to become more common. This isn t a bad thing. Most Online Diagnosers still consult a doctor after doing their own research and many of them handle the information well. But it does affect the doctor-patient relationship. So what can be done to minimax drawbacks and benefits?

10 The Doctor-Patient Relationship The doctor-patient relationship is built on knowledge asymmetry. The patient is vulnerable and must trust the knowledge and skill of the doctor can restore their health. Consistent with paternalism. A better-informed patient reduces the knowledge asymmetry. The Online Diagnoser still relies on the knowledge and skill of the doctor, but they take a proactive in the maintenance of their health. Consistent with movement away from paternalism and toward shared decision making.

11 The Doctor-Patient Relationship Patients report being skeptical of OHI mediated through social media, or by online doctors without access to their records. Patients are still seeing doctors and still report general awareness of the importance of physician expertise, and many express worry that their online research will offend doctors. Doctors generally do not report feeling threatened or undermined by patients doing their own research. (Silver 2015, Stevenson 2007)

12 What Can Clinicians Do? Know the resources Start the conversation Foster collaboration

13 Know the Resources

14 Start the Conversation Ask patients about the research they have done, if any. Ask about the resources they use and offer recommendations. Make it clear that patient research is acceptable and welcomed

15 Foster Collaboration By engaging with the research completed by Online Diagnosers, you demonstrate that you share that same interests as your patient, building trust.

16 What Can Patients Do? Know the resources Write down your questions Foster collaboration

17 Know the Resources Learn how to identify high quality sources. Learn when it s time to talk to your doctor.

18 Write Down Your Questions As you research, write down questions for your doctor. If something doesn t make sense, your doctor will be able to help you make sense of it. Approaching with questions promotes collaboration instead of challenge.

19 Foster Collaboration Be upfront about your research and look for opportunities to collaborate.

20 Discussion MAT THEW PJECHA, MSPP