Patients seek Internet information to start dialogue with physicians

Richard Kravitz, MD, wasn’t sure how to react the first few times patients showed up with stacks of paper containing online research they conducted.

“But now I have kind of developed a more relaxed way of responding,” said Dr. Kravitz, an internist at the University of California, Davis’ Center of General Medicine.

He co-wrote a study that appeared online May 16 in the Journal of Health Communication that he hopes will help other physicians become more at ease when dealing with Internet-searching patients. One of the most important things doctors should know, he said, is that patients aren’t going online because they don’t trust their physician or are skeptical of their diagnosis. They are searching the Internet to become more engaged in their care.

Dr. Kravitz and fellow researchers surveyed more than 500 members of online support groups who had scheduled physician visits.

They found that distrust of doctors was not a motivating factor for patients. Rather, patients were motivated to search online if they perceived their illness as serious or they felt they had some personal control over their illness. High health literacy also was a strong predictor of whether someone would seek information online.

Study co-author Xinyi Hu, a master’s student in the Dept. of Communications at UC Davis, said she was interested in examining the physician-patient relationship because patients now play a more active role in their health care than in the past. Many are taking on that role by turning to the Internet.

“So it is interesting to know what motivates patients to do an Internet search before their medical appointments,” Hu said.

The study looked only at patients involved in online support groups. A study published in March by the Pew Internet & American Life Project found more than 80% of Internet users go online to search for health information.

Hu said because so many patients now consult the Internet before their medical appointments, physicians need to prepare for patients bringing in information to discuss with them. The Journal of Health Communication study found almost 70% of the subjects planned to ask their doctor questions about the information they found, and 40% had printed the information to take to the appointment (link).

Dr. Kravitz said patients, especially those with rare conditions, can be a good source of new information for physicians. But while patients may be proficient at finding material online, the doctor’s role is to help them sort through it and assess whether it’s credible, he said.

“Doctors should try to relax about this and just engage in conversations with patients about the information they bring in, some of which will be truthful and relevant, and others won’t be,” Dr. Kravitz said. “We can’t do anything else except to have a candid dialogue about it.”