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Online health information undermines parental trust in physician diagnosis
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Parents were more likely to trust their child’s physician when the physician’s diagnosis corresponded with information the parent procured online, but they were more inclined to seek a second opinion when their own search results contradicted the diagnosis, according to research presented at the 2017 Pediatric Academic Societies Meeting.
“Parents need to discuss all of their concerns regarding differential diagnosis or other information they may have garnered from internet searches with their doctor,” Ruth Milanaik, DO, FAAP, lead author and associate professor at the Hofstra Northwell School of Medicine, told Infectious Diseases in Children. “This is essential in order to fully understand their physician’s thought process. Allowing your physician to fully explain their reasoning can resolve parent and patient concerns and eliminate delays in treatment.”
To analyze parental trust levels regarding their child’s diagnosis given by a medical professional, the researchers conducted a study that was released on Amazon’s Mechanical Turk. Parents who had at least one child under the age of 18 were given information on a child who had “a rash and worsening fever for 3 days.” Once the story was distributed, 1,347 participants were split into three cohorts: scarlet fever, Kawasaki disease or control.
If assigned scarlet fever or Kawasaki disease, researchers exposed the parents to doctored screenshots of internet searches that suggested the symptoms were related to one of the two conditions, whereas those in the control cohort received no internet search results. Every participant was then informed that a doctor had diagnosed the child with scarlet fever. After diagnosis, parents ranked their trust in the doctor from 1 (not at all) to 7 (completely), and the average trust and likelihood ratings were analyzed in all cohorts.
Each cohort differed greatly from each other in terms of trust and chances of seeking a second opinion. When compared with the control group, the highest mean trust was seen within the scarlet fever group as opposed to the lower mean trust found in the Kawasaki disease group. Those in the scarlet fever group were less likely to seek a second opinion compared with a higher likelihood in the Kawasaki disease group.
“The internet is a powerful search tool that is widely used by parents and patients alike. Physicians must be aware of the influence of the internet and address all concerns on internet information,” Milanaik said in an interview. “It must become common place for physicians to ask if the patient has any concerns regarding information gleaned from web sources.” – by Katherine Bortz.
Reference:
Milanaik R, et al. “Paging Dr. Google: The effects of online health information on parental trust in pediatricians’ medical diagnoses.” Presented at: The Pediatric Academic Societies Meeting; May 6-9, 2017; San Francisco, CA.
Disclosure: The researchers report no financial disclosures.
Perspective
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Sandra F. Braganza, MD, MPH
Physicians should be aware that patients are actively seeking out information in other sources such as the internet; we should assume that patients will try to find additional information about their diagnosis, whether through online research or by asking family and friends about their own experiences. Hence, actively asking about patients’ current knowledge of a particular diagnosis should be part of what physicians incorporate into their day-to-day practice.
While the internet provides a lot of information, physicians can also help guide patients to interpret what information they gather. As physicians, we should provide reliable medical information to our patients, including giving patient education handouts on preventive care or on specific diagnoses. Most importantly, an open dialogue remains the best approach in building trust with patients, and physicians should always encourage open discussion about medical care with their patients and families.
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