The Google Pre-consultation

Patients frequently preface a question with “I know doctors hate it when their patients look stuff up on the internet, but…” In typical doctor fashion I interrupt them at this point and say, “No I don’t, I like it when patients do that.” It takes a moment or two for that to take. Then they nod and ask whatever is worrying them that they’ve found on line.

The Google “pre-consultation” is a fact. According to research done by the Pew Research Center, 72% of internet users have searched the internet for health information.[1] Many doctors I know, or at least the ones on social media, will pro-actively ask their patients “what did you read about it online?” This often relieves a couple of anxieties. First, that the doctor will negatively judge the patient for checking on line and secondly, the patient can proceed to ask questions about what is worrying her or him.

So when you come in to see me, instead of the “petit papier” with all your questions, I’ll expect them to be in a list on your smart phone or tablet (the paper is OK too). And if you want to send them in ahead of time, be my guest! Go to RelayHealth.com, register and send me your questions before your appointment. We can save time and cover more ground that way.

Oh, and when you are researching on the web, be careful out there. You can find lots of wrong information, chicanery and just plain bad advice on the internet. Here are my recommended web sites for disease searches:

If you are looking for patients with similar conditions to yours, there are some great patient communities out there as well:

And always, if you think of a question you forgot to ask please contact me through RelayHealth.com.

1. http://www.pewinternet.org/Commentary/2011/November/Pew-Internet-Health.aspx

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The Lurking Physician

In addition to reading a number of medical bloggers, I “lurk” on twitter chats and try to watch twitter updates from the 88 people I am currently following. The majority of the people I follow are doctors who are interested in how social media can help patients, plus a few “learning” entities like Brainscape just to improve my language studying skills (which I highly recommend). I am just a neophyte to Social Media but am excited by its potential for my patients.

Brainscape

Suddenly the ability to followup with patients directly without a medical assistant playing messenger in between seems more attainable. Communications would be cleaner and both physicians and patients would be better served. Right now I do this on a small scale by using email but this is fraught with difficulty. Patients send me their information and sometimes they cannot open my email response because it is encrypted (per HIPPA requirements). Other times their emails are caught by my spam filter and I never see them! As I’ve written about in previous posts, there are recommendations by august bodies like the AMA on how to use email professionally but frankly, they are both out-of-date and a little out-of-touch with their recommendations. However, having said that, HIPPA fines are substantive so no one wants to be caught in the wrong while communicating with patients.

In the meantime, patients are becoming more web and social media savvy. It is exciting to have a patient come in who has been on the Mayo clinic website and is asking about what preventive steps they should be taking instead of me initiating the discussion. It makes me feel like a partner in their care instead of a mother giving advice. I am a mother and I enjoy that role. Nurturing is part of healthcare but when I feel more like the disciplinarian then an advisor, neither I nor the patient are likely to benefit.

The “early adopter” physicians and e-patients on Twitter, Facebook, Google+ and LinkedIn, among others, are working hard to improve the lines of communication so that patient care is better. It’s an exciting time to be involved and I am looking forward to learning more and sharing a lot.

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