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Dr. Google? Americans go online for health info, but Pew says doctor still primary

“Dr. Google” has a booming virtual medical practice, but it doesn't compete with a real health professional when it comes to providing care and information about health concerns, according to a new survey from the Pew Internet and American Life Project.

It found most Americans looked online for health information in the last year and one-third used the Internet as a diagnostic tool, but patients still relied primarily on their doctors or other health professionals for treatment, information and guidance. They also found that many people hit “pay walls,” which asked them to pay for information they sought; most declined and tried to find the same information elsewhere, though some paid and others gave up the search.

“Offline still dominates most healthcare situations. It's a very deep ancient instinct to want to have hands-on care,” said Susannah Fox, associate director of the Pew Internet Project.

Self diagnosis?

The report is not the first time Pew has considered how people use the Internet to get health information. But this time, Fox said, they probed deeper to try to answer questions that have sprung up around online health searches, like whether people are using them to diagnose themselves and whether they follow up with doctors. They found people are going online to fact-check themselves, she noted, or to refresh themselves on information. But when it's something serious, they are likely to turn to a doctor for help.

“We do find that people go online to prepare for a doctor's appointment and to recover from a doctor's appointment,” she said. “They are using it as a tool, among many tools.”

Of those who thought they found a diagnosis online, the report shows 46 percent then consulted a medical professional, 38 percent said they could take care of it at home and 11 percent said it was both, or in-between.

People go online for all sorts of things and questions about health are a natural extension of that, said Dr. Wendy Swanson of Seattle Children's Hospital and The Everett Clinic. The difference comes in the kind of health problem one is trying to solve: There's a difference between seeking information on a wart and a possible tumor.

“We go to search engines and ask questions. I think it would be really strange to not look it up, where we look up everything else,” Swanson said. “I don't think Dr. Google will ever replace the beautiful and sacred thing that happens when you find a doctor you trust” enough to take medical concerns, she said, adding the Internet can never provide a physical examination or replace the human interaction between doctor and patient.

“We are human beings; we want humans to help us understand our suffering and our worries. But I think we as doctors should embrace it and let it help us,” she continued. “Doctors could do a better job of creating helpful content for patients or directing them to the best that's out there. 'Here are four Websites I think you should go to for more information.'”

A partnership

What Dr. Bryan Vartabedian sees in his practice at Baylor College of Medicine is similar to the study findings: “Patients frequently use the Internet to access information, and it potentially helps them understand what's going on. But all of the basic dialog is happening in real life. The connection between provider and patient in real life remains the final step in all these. I see patients developing a relationship with information; they use the Internet to accent what they understand is going on with them. But they also have a relationship with me.”

Vartabedian says people are smarter than they were given credit for amid early fears that patients in droves would be sucked in online by bad information. They have a decent sense of what represents reasonable information and what doesn't; that's digital health literacy. And often what they've found online provides some background or understanding that enhances the conversation with a doctor as they apply it to a real situation.

“I accept the fact that patients are trying to understand their own conditions, and I have found almost universally patients respect the relationship they have with me.”

“As health care providers, we sometimes dread the stereotypical hypochondriac patient who comes in with 10 unlikely diagnoses they've found online,” said Dr. Roni Zeiger, CEO of Smart Patients, who is also former chief health strategist at Google. “We need to move beyond that stereotype. It does happen, as do many more patients who have thoughtful questions and ideas about what they've learned and considered. Instead of hoping to avoid this issue, I think doctors should ask their patients what they've learned online and also share with patients online resources they find most reliable.”

Vartabedian noted with some surprise the finding that fewer than 20 percent of patients use the online physician review and rating sites and that even fewer patients take the time to rate their doctors. “A few years ago, we thought that would be a great source of information for patients, but it has turned out to be a site for polarized patient opinions,” he said, such as “My doctor was 20 minutes late.” The information is not always useful.

As for the pay walls, “There's been a lot of discussion about the impact of having scientific journals and others' articles behind a subscription wall,” said Fox. “Nobody knows. One in four who look say they were asked to pay for access to something they wanted to see. Some tried to get around the pay wall and find the information elsewhere. Another segment gave up. You wonder what the lost opportunity is there.”

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