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Spring 2014
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Doctors would do well to make peace with the Internet.
Several weeks ago one of my patients asked if she could try a weight loss supplement she had read about on the Internet. Would it cause any problems with her existing medications? Did I know anything about it? Many doctors dread the so-called “cyberchondriac” who arrives at the appointment with an armful of computer printouts from dubious websites, convinced that “Dr. Google” knows best. What do you say to these patients? In the medical community, there are two markedly different responses to patients’ use of the Internet for health information: resistance and frustration; and collaboration and adaptation. The way that we respond to patients’ increased autonomy can shape the doctor-patient relationship and even treatment outcomes.

Those of us who have been practicing for a number of years can remember a time when physicians enjoyed considerable deference in medical decision making. Patients acquiesced to their doctors’ suggestions with little questioning or complaint. We did not need to squeeze many patients into one day in order to cover the expense of our malpractice insurance, and we did not have to spend hours filling out paperwork for insurance companies. We had more time to talk to our patients and answer their questions. Now, when patients arrive with information they have gathered on the Internet, it is often difficult to find the time to help them to understand it.

In recent years, numerous factors have contributed to a change in the model of care, not least of which is the adoption of Internet technology by patients who wish to be more actively involved in decisions about their health care. More and more often patients are researching their conditions and their symptoms online and joining Internet support communities like PatientsLikeMe ( to share advice and learn from other patients. When they want answers to medical questions, they often first seek information through search engines rather than through the doctor’s office staff. Some patients even order treatments online without telling their physicians.

To continue to provide high-quality health care, we need to adapt. We need to be open to a collaborative relationship in which empowered patients take a proactive role in their health care. Although many of us would like to believe that we have an encyclopedic memory of every possible diagnosis and treatment, we are not omniscient. We must be willing to read any information our patients bring to their appointments, and we should be ready to refer them to more reliable websites.
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