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Don’t dismiss web savvy patients as cyberchondriacs, doctors told

The practice is going to become more common, so work with them, says medical defence body

Caroline White

Tuesday, 24 March 2015

Doctors should not dismiss or feel threatened by patients who self-diagnose on the internet before attending appointments, says the medical defence organisation MDDUS, following the results of a survey indicating a rise in the practice.

A recent survey by the Astellas Innovation Debate held last month revealed that three out of four GPs had noticed a substantial increase in the number of patients ‘self-diagnosing’ from the internet over the past year.

And one in five (21%) had seen an increase in patients presenting at the surgery with data generated from health apps and ‘smart’ devices.

It may be tempting to label them ‘cyberchondriacs’ or the ‘worried well,’ but the reality is that some patients who are anxious about their health use the internet to diagnose themselves with everything from brain tumours to an exotic disease such as dengue fever, says the MDDUS.

“Such is the growing role of the internet in society today, it is perhaps inevitable that some patients will attempt to self-diagnose using information obtained online,” says MDDUS medical adviser Dr Greg Dollman.

“It can be a fine balancing act for doctors when faced with patients who, prior to their scheduled appointment, have already sought a ‘second opinion’ via their health app or a Google search.”

Some doctors may feel concerned over losing control of the consultation and feel that time that should be used to examine the patient may instead be spent looking through their findings.

“Some doctors may feel anxious, intimidated or even threatened by web-wise patients arriving at their practice armed with a dossier of medical information,” says Dr Dollman.

“It can be disconcerting to have a patient showing you information from their health app or turning up with print out of their symptoms, complete with their own diagnosis.

“While internet information can be inaccurate or misleading, patients should be encouraged to take an interest in and be responsible for their own health and, by working together with the doctor, they can gain a better understanding of any condition or symptoms they have,” he insists.

He advises doctors to listen to what every patient has to say and that includes carefully considering information presented to them by the patient. Working in partnership with the patient involves sharing decision making where possible and respecting their views, he adds.

"It is unlikely that doctors will have every diagnosis at their fingertips and they should welcome a patient's considered and subjective review of their own symptoms and circumstances as both an occasion to build on the doctor-patient partnership as well as a helpful opportunity for continuing their own professional development.

“As with all medical consultations, a doctor should acknowledge the information provided by a colleague or patient, using this as a starting point for their own attentive and personalised review."

MDDUS has come across many cases where patients have requested specialist medicines from their doctors as a result of their own internet research.

“Doctors are reminded of their professional duty to work within the field of their own knowledge and expertise. Furthermore, doctors are entitled not to provide treatment requested by a patient that they do not believe is in their best interests,” cautions Dr Dollman.

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