Reports

A number of items in the medical news and blogosphere over the past week have focused on patients who research their own (or their friends’ and family’s) health conditions online, and how those patients relate to their doctors.

First, the Center for Medicine in the Public Interest released a report entitled “Insta-Americans: The Empowered (and Imperiled) Health Care Consumer in the Age of Internet Medicine” [856 KB PDF] which led to a certain amount of press coverage (like this TV news item from KVUE-24 in Austin) looking at the high proportion of health-related search results that point at unreliable sources. It’s too bad the CMPI missed a really good opportunity to promote specific reliable health search sites, but fortunately they did reiterate 10 of the 12 items the National Cancer Institute’s excellent guide, “How to Evaluate Health Information on the Internet.”

Second, pediatrician Rahul Parikh MD wrote a piece entitled “Is There a Doctor in the Mouse?” in the online magazine Salon, which responded in part to a November article, “When the Patient is a Googler,” by Time magazine medical writer Dr Scott Haig. Parikh says in part:

“…a 2001 study of doctors showed that barely half of them encouraged their patients to go online (although the trend has been increasing over time), and 80 percent actually warned them against doing so. In one regard, this is simply bad business. Pew tells us that patients either fire doctors unwilling to help them with the Web or keep going online without telling them. More important, when patients do venture online themselves, they can sink into a swamp of outdated medical studies, confront a lot of misinformation, and risk creating a rift in the doctor-patient relationship.”

Like the CMPI report, Parikh cites the struggle that doctors have had against Internet misinformation regarding “links” between vaccines and autism. But Parikh sees that struggle as an argument for doctors to better engage the Internet, point their patients toward reliable sources, and promote Open Access medical literature that can help to rebut and dispel the misinformation. He continues:

“Today, there are many accurate, high-quality health sites, and doctors should make it a standard practice to recommend them to each and every patient. Besides reducing the randomness of a Web search, this can reinforce a physician’s advice during a visit, which is especially helpful, as studies show that patients typically remember no more than half of what their doctor tells them.”

For public health practitioners, the act of going to see a doctor is evidence of a patient’s motivation to improve his or her health, so it’s an optimal time to harness that motivation by proposing healthier behaviors. Librarians, likewise, know that when a patron is motivated to address a particular information need, it’s a particularly “teachable” moment to introduce effective information-seeking behaviors. When patients come to their doctors with information they have found on the Internet, doctors can either look at it as a threat, or as an opportunity to engage a motivated and interested patient to take responsibility for his or her health information needs.

As librarians, how can we help? One small way is to encourage doctors to engage their patients and direct them to reliable online sites with materials like the new “MedlinePlus for Health Professionals” brochure [PDF format] [Word format] and materials from the InformationRx Store. It’s unfortunate that both CMPI and Parikh missed out on mentioning MedlinePlus — because it’s a lot to ask of doctors to keep up with the huge proliferation of consumer health sites as well as their own professional online resources, but if we can start with just one site they can consistently feel confident recommending to their patients, MedlinePlus is a great place to start.