How did you manage a Google patient

How "Dr. Google" is changing the doctor-patient relationship

More than every third Austrian has already researched a personal health question on the Internet. This is shown by a survey by the opinion research institute IMAS. This development also changes the relationship between doctor and patient.

Contrary to what is sometimes feared, however, very often for the better, as research on this still very young topic shows. In any case, it is important to consult a real doctor and not "Dr. Google" despite all the preliminary research for clarification - the Flemish government also points this out in a dramatic video.

Mutual benefit

"The Internet is so attractive for patients because it prepares a wealth of information in an appealing form - and it is constantly updated, which is of course crucial in the medical field," says Ulrike Felt, professor for science and technology research at the University of Vienna who has been dealing with this topic for a long time.

In the past, laypeople had little access to understandable information about diseases - you had to confide in the doctor, you could only get a second and third opinion. With a simple cold you usually didn't do that.

Conversation at eye level

Today, thanks to Google, Netdoktor & Co., this is easier than ever. And the positive effects predominate, reports Felt: Because the patients are more well informed than ever before, the doctor's consultation is no longer a one-way street, but increasingly a conversation at eye level. 15 percent of those questioned stated in the IMAS study that they use the Internet "intensively" for research on medical issues.

By far the most frequent (60 percent) doctors, pharmacists and nurses are consulted first. What even surprised Felt, but her results show: "The Internet research does not question the doctor, but may even take it more seriously." Both sides would benefit from this, because the "cooperation" of Dr. Google and real doctor even have higher compliance, i.e. more strict adherence to the prescribed therapy measures.

Further clarification

In a study of more than 600 patients, Felt and her colleagues observed a "division of labor" behavior in many. These patients have already informed themselves in a certain direction in advance, but still turn to their doctor for further clarification, whom they believe more than the Internet in case of doubt.

Then there are also those patients who want to check the doctor. According to Felt, this is the smallest group in terms of numbers, and it is not dangerous either: as long as these people still go to the doctor and do not postpone an important examination or their therapy, it is not a problem. It could only become problematic if they were given false information and did not seek expert opinion.

Dangerous cyberchondria

Dr. Google with it: for example the new phenomenon of cyberchondria, a form of hypochondria that is caused and often exacerbated by the Internet. Often people googled for very unspecific symptoms such as headache, which can occur with a great number of diseases - but it does not always have to be a brain tumor. The doctor still has to take the underlying concerns seriously.

In addition, the mass of information overwhelms not a few, as Felt reports: "The majority of patients find it difficult to deal with the enormous amount of information correctly. You have to take care of selection and interpretation yourself very actively, which many have simply never learned. "

Digital divide

The "digital divide", ie the different uses of the Internet, also exists in the medical sector: there is a tendency towards young and highly educated people who turn to Dr. Contact google. Even if this "digital divide" is slowly narrowing: Almost everyone can still learn something about how to deal with it correctly, says Felt. 90 percent of those surveyed use Google exclusively for research, and most only use the first page of search results. The best ranked results do not always have to be the most useful.

But not only education and age, but also the respective health system play a major role: in Great Britain, for example, people wait much longer for an appointment with a specialist than in Germany. And unlike in Austria, you can't easily change it - it makes it more difficult to get a second opinion. That is why googling diseases is much more widespread among the British - about every second person does it, often in the hope of being able to save themselves a visit to the doctor altogether.

New study

E-learning expert Michael Kopp from the University of Graz is also looking into the consequences for the doctor-patient relationship. "Some patients make their own diagnosis and only go to the doctor to get their prescription," says Kopp. The subsequent patient consultation is often more time-consuming than a regular examination with diagnosis.

He is currently working with sociologists, medical ethicists and doctors on a new study with the help of a Massive Open Online Course, in which patients can use schematic images and sequences to see certain symptoms and then find a diagnosis. "Kind of like Dr. House, just on the Internet," says Kopp. The course is scheduled to start in autumn and the first results should be available in 2016.

possible alternatives

In order not to become completely dependent on Google and its search algorithm, Felt refers to the health seal HON (Health On Net), which has been specializing in the certification of medical websites for twelve years. Official websites of the Ministry of Health and insurance companies could also help to find out more about specific diseases.

But there are also good alternatives to Dr. Google. For example the Danish platform "Find Zebra", a free web lexicon aimed at patients with rare diseases. Crowdmed is also ideal for people with rare or particularly therapy-resistant diseases: There, users can post their entire medical history and findings online.

Medical detectives

For an amount between 99 and 500 US dollars, depending on the package, the patient file is then forwarded to several "medical detectives", medical investigators such as doctors or even patients who are affected - in the hope that multiple opinions will lead to a better result . Crowdmed would like to ensure the quality of the diagnoses through a points system.

To what extent these new services and Dr. No one can say for sure at the moment that Google will continue to change the doctor-patient relationship. In the best case scenario, however, both sides benefit. (Florian Bayer, derStandard.at, February 25, 2015)