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Challenging Dr. Google

David Epstein, MD, discusses the challenges of managing patient encounters after patients have consulted the internet first.

Most clinicians have gotten used to hearing about what Dr. Google recommended to their patients.

Dr. Google does hold significant authority and prestige in the community and may be more revered than most non-digital medical providers by the public.
So it goes without saying that clinicians may be intimidated by this medical authority.
How should the medical community deal with this medical provider that has never actually examined a patient or engaged in discussions during a medical encounter?

An article that was written to help medical providers best address patients who visited Dr. Google’s office before them.

It outlines a sensitive approach to not shaming or attacking patients for getting their information from the famous digital resource. It is based on a 3 “W” framework:
  1. Wait – respond with empathy first and resist the urge to immediately respond with data
  2. What – demonstrate curiosity by soliciting a description of what was found, being open to the possibility that it may be valuable, and sensitively exploring what may be misinformation
  3. Work Together – negotiate a plan and discuss how or if to incorporate the information that was found on the internet
This emphasizes a collaborative, non-judgmental approach that promotes listening and exploring the information that the patient has acquired from their consult with Dr. Google.
The information that patients obtain from the internet should not be threatening to medical providers during the medical encounter. Although there is a significant amount of misinformation and disinformation on the internet, we should be able to communicate with our patients to navigate and direct them to accurate medical information.

All the while, we need to understand why they sought the advice of Dr. Google.

Fear, anxiety, loss of control, and concern are likely reasons for searching for answers on the internet and we need to be sensitive to that.
Patients, for the most part, are not going to the internet to consciously challenge their medical providers. There is a reason for seeking the opinion of Dr. Google and we should not be disappointed in them for searching.
While I’m sure that this approach is not 100% effective, it at least gives us a framework to address what Dr. Google has advised and establish our position in a manner that gives us credibility and establishes trust.

Credibility and trust are the keys to challenging the authority and prestige that Dr. Google has established.

This is not to say that Dr. Google is bad. There is an amazing amount of information that is available on the internet. But, information is not knowledge or wisdom.
While we will never have the sum of information in our heads that Dr. Google has, medical providers have the critical thinking and clinical experience to help filter the internet information and provide patients with a strong second opinion to that of Dr. Google.
How do you manage patient encounters where the patients have visited Dr. Google first?

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