Two weeks ago, I wrote that the key to understanding the Pew Internet report on patient use of online health info wasn’t looking at online activity, per se, but rather how that online activity impacted real-world interactions with doctors. In a world that is increasingly virtual, health care remains a hands-on activity.
It should be taken for granted now that patients will go online in search of information. But the impacts of that go well beyond the creation of a more educated patient population. Self-guided internet research has profound implications for the doctor-patient relationship, a reality that was spelled out explicitly in a May Oncology Nursing Forum piece that looked at what happened to cancer survivors who had participated in the Association of Cancer Online Resources’ online cancer communities or e-mail lists.
Many of the results were, unsurprisingly, positive. Patients became empowered and were able to play a more active role in their care. But there was a dark side, too.
Patients who went online to be educate also came away from the experience disenchanted. They realized that they may not have received optimum, evidence-based care. They worried that information was kept from them by health care providers, either intentionally or because the providers simply didn’t have the knowledge.
The ONF piece didn’t explicitly say whether patients were better or worse off, on balance, for their online exploration, but it was clear that Internet research had a troubling impact at that key nexus between the computer screen and the doctor’s office. It’s hard to hold patients responsible for the disconnect. Instead, this argues that providers have to be as web-centric as the patients they see.
There are a number of well-established reasons for doctors to log on (for regular, thoughtful arguments in support of wired providers, read Dr. Bryan Vartabedian’s 33 Charts blog), most of them proactive. But the best argument might be the reactive one raised by the ONF article: health care providers need to know what their patients are seeing and react accordingly.
The rationale here is not to improve clinical judgments — I operate under the assumption that most docs, most of the time, make the right call — but rather improving doctor-patient relationships. The Internet is a great tool, and empowered patients are a major part of the future of health care. But those gains get eroded if empowerment turns to disenchantment in the waiting room. Embrace of technology isn’t a luxury anymore; it’s the baseline. Any less, and the patient experience gets degraded.