June 2000 Bulletin

Have patience with Internet savvy patients

Physicians should be open-minded and perhaps learn something new

By Sandra Lee Breisch

You’ve got some Internet savvy patients who walk into the exam room with a bundle of information secured via medical web site searches.

They’re keen to point out the medical knowledge they’ve just acquired. Or, they might even tell you what treatment or medication you should prescribe based on their web search.

What’s a busy physician to do with these web surfing patients? And how do you make the Internet a partner–and not an adversary?

"Don’t fret," points out J. Sybil Biermann, MD, assistant professor, Orthopaedic Oncology, Comprehensive Cancer Center at the University of Michigan, who has lectured on this topic at the Academy’s Annual Meeting. "React appropriately to your patients’ newly obtained knowledge and remain open-minded. This way, you’ll engender their trust. Physicians have to recognize the opportunity to learn from our patients, but we also have to be prepared for the day when patients come in with medical information we haven’t heard of yet."

But one patient who overwhelms you with Internet-accessed material could result in scheduling delays and less time spent with another patient. As Dr. Biermann points out, "you can’t turn a patient away" or "automatically presume" that what he or she is telling you has no merit.

Let’s say a patient approaches you for an interpretation of information they obtained off the Internet. "Acknowledge their source, but help him or her understand the variability of Internet information [that’s out there] and the importance of looking for authorship on posting sites," stresses Dr. Biermann. "Don’t be afraid to point out that information found on an individual’s web site or a commercial organization’s site may reflect only one opinion and is more susceptible to bias and it is not usually peer-reviewed like the web sites of the AAOS, universities or governmental agencies. Point out that nonpeer-reviewed information might not be current and/or have incorrect information posted."

If a patient comes in with information that you’re not familiar with, Dr. Biermann says to "recognize you’ve got an opportunity" to learn from that patient. "I’d suggest doctors say, ‘I’ve not reviewed that particular information, but I would be happy to do so. I’ll get back to you to see if this medication or procedure would be appropriate for you.’"

Physicians and their staff also can be instrumental in educating their patients by recommending specific web sites in printed form.

But if you’re a neophyte to the Internet and/or don’t have your own web site, Dr. Biermann says, "you’ll lag behind times." To develop "good web content," she suggests physicians work with a professional organization like the AAOS. "By working with the AAOS or other groups, you’ll be intricately involved in putting medical information out there and know the information will be accurate. Remember, you don’t have to be a computer programmer or even a regular computer user to contribute content."

Physicians should be aware that this trend of Internet usage among patients and physicians will continue, says Dr. Biermann. "But remember, patients who are very well-informed about medical care via the Internet or otherwise are more likely to follow your recommendations which should ultimately lead to better outcomes."


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