The doctor as the second opinion and the internet as the first
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The doctor as the second opinion and the internet as the first l.jpg

The Doctor as the Second Opinion and the Internet as the First

By: Lisa Neal Gualtieri

Health Communication Program

Tufts University School of Medicine


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Introduction First

  • The introduction of the Internet to many different domains has dramatically changed how people get the information and services they need.

  • Finance and Travel

  • What about Healthcare?


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Healthcare, and the Internet First

  • Initial use – online support groups

  • Expansion – used to learn about a disease, to determine whether professional medical care is needed, to diagnose, to learn what treatment options exist, and for peer support


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Poor Health-Literacy Skills First

  • Health literacy

  • Problems Searching Online

  • Results – Patients cannot understand or act on medical information whether it be received online, or by doctor visit


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Problems, Made Worse First

  • Poor health literacy compounded and made worse

  • There is reliable health information online, but…


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Reliable Information First

  • Some people start looking for health information at well-known and established sites

  • More then half of health-information seekers reported that their most recent online health-info session affected how they care for themselves or someone else

  • Decisions without the awareness of or feedback from professionals


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Internet as the First Opinion First

  • Internet – convenient, easy to use, reflexive use to diagnose a problem, look up symptoms, and determine what to do

  • Professional medical care becomes the second opinion

  • In some cases, the second opinion, is not even taken into consideration, and many people attempt to solve their health problems on their own

  • In other cases, the first opinion from the internet leads to seeking the second opinion.


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Communication First

  • Frequently neither the patient tells the doctor about their internet provided first opinion, nor does the doctor inquire about it, for a multitude of reasons


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Consequences First

  • Strong Doctor-patient relationship is based on trust, not sharing crucial information about previous research, and concerns, can erode this trust, without the doctor even being aware of it

  • Third opinion following doctor’s visit – confused, immediately go to Internet, again.


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True Stories First

  • Whooping Cough – Mary Ann P.

  • Bat Bite – Diana C.

  • Uterine Cancer – Julie Z.


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What Can Patients Do To Use the Internet More Effectively? First

  • Strive to become empowered healthcare consumers

  • Guidance by their healthcare providers about how to integrate their internet research with their visits


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What Can Doctors Do? First

  • Doctor’s need to acknowledge their patients concerns

  • They can give recommendations

  • Collect information about internet use through surveys and such


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What Can HCI Professionals Do? First

  • Collaborate with the medical community to develop a gold standard for consumer health web site design

  • Ultimately, anyone using a health website is trying to feel better or stay well, the design should address that


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Conclusions First

  • The medical community today fails to acknowledge the extent at which patients do health-related online research.

  • More information is needed about the reasons patients rely heavily on the Internet.

  • Why do they use it for their first opinion? Why do they not disclose to physicians any fears or concerns regarding their online diagnoses?

  • Patients benefit if they are more knowledgeable and have better relationships with their doctors. Doctors benefit if their patients are more knowledgeable and less confrontational or fearful.

  • With 80% or more of American’s of all ages, to say nothing of Internet users in other countries, using the Internet for health, improving healthcare should be a collaborative priority of the medical and human computer interaction communities!


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