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the doctor as the second opinion and the internet as the first

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

By: Lisa Neal Gualtieri

Health Communication Program

Tufts University School of Medicine

introduction
Introduction
  • 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?
healthcare and the internet
Healthcare, and the Internet
  • 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
poor health literacy skills
Poor Health-Literacy Skills
  • Health literacy
  • Problems Searching Online
  • Results – Patients cannot understand or act on medical information whether it be received online, or by doctor visit
problems made worse
Problems, Made Worse
  • Poor health literacy compounded and made worse
  • There is reliable health information online, but…
reliable information
Reliable Information
  • 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
internet as the first opinion
Internet as the First Opinion
  • 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.
communication
Communication
  • 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
consequences
Consequences
  • 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.
true stories
True Stories
  • Whooping Cough – Mary Ann P.
  • Bat Bite – Diana C.
  • Uterine Cancer – Julie Z.
what can patients do to use the internet more effectively
What Can Patients Do To Use the Internet More Effectively?
  • Strive to become empowered healthcare consumers
  • Guidance by their healthcare providers about how to integrate their internet research with their visits
what can doctors do
What Can Doctors Do?
  • Doctor’s need to acknowledge their patients concerns
  • They can give recommendations
  • Collect information about internet use through surveys and such
what can hci professionals do
What Can HCI Professionals Do?
  • 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
conclusions
Conclusions
  • 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!