Googling symptoms may improve patient interactions with physicians

Anecdotal evidence suggests it might not be the best idea for individuals to self-diagnose after searching the internet for symptoms. A sore throat could just be a sore throat—or, after cruising a few medical websites, it could be proof that a patient’s demise is imminent.

But outside of stories such as these, how does a patient’s internet search behavior impact an ensuing interaction with a physician in the emergency department (ED)? A team of Australian researchers found those who consulted online resources had better interactions, because it led to more informed discussions while not undermining trust in diagnoses and treatment plans. Still, while the activity was generally considered positive, searches could increase patient anxiety.

The research—led by Anthony M. Cocco, with St.  Vincent’s Hospital and the University of Melbourne in Australia—was published online Aug. 20 in the Medical Journal of Australia.

“We found that searching the internet for information before presenting to an ED generally had a positive effect (from the patient’s perspective) on the doctor–patient interaction,” Cocco et al. wrote. “Specifically, patients reported they were more able to ask informed questions, communicate effectively, and understand their health provider. This indicates that searching before attending an ED may have a positive effect by informing patients and improving communication between patients and health practitioners, consistent with earlier findings. In addition, it was shown that searching does not usually reduce the patient’s confidence in the diagnosis or treatment plan provided by the practitioner, nor is it associated with reduced compliance with these treatment plans.”

The team focused on 400 patients who presented to two large tertiary referral center EDs in Melbourne in early 2017, with a mean age of 47.1 years and 51.8 percent were male. Nearly half—49 percent—regularly searched the internet for medical information, and 34.8 percent looked into their current medical issue before going to the ED.

Those who had looked for information online completed the Internet Search effect on Medical Interaction Index (ISMII). Results from ISMII scores included:

  • Internet searches had a net positive on 150 of the 196 people (77.3 percent) who regularly look online, 32 (16 percent) reported a negative effect and 14 (7.1 percent) reported no effect.
  • 155 respondents (79.5 percent) agreed or strongly agreed that internet searching helped them understand their physician during the consultation.
  • Meanwhile, 76 people (40 percent) said looking for information on the internet led to increase worry or anxiety.
  • 153 respondents (78.9 percent) claimed the internet-derived information never or rarely led to doubt about diagnosis or treatment, and 174 (91.1 percent) never or rarely changed a treatment plan from a doctor because of online health information.

“Searching for online health information had a positive impact on the doctor–patient relationship, particularly for patients with greater e-health literacy, and was unlikely to cause patients to doubt the diagnosis by a practitioner or to affect adherence to treatment,” Cocco and colleagues wrote. “We therefore suggest that doctors acknowledge and be prepared to discuss with adult ED patients their online searches for health information.”