Attitudes and experiences in respect of patients who conduct research online
Many of the respondents have a rather critical view of online research into health and disease-related topics; 53% assume that regular consultation of information on the internet tends to have negative consequences for the doctor–patient relationship (rather than positive consequences 19%, undecided 28%). Online research is regarded more favourably for clarification and health-related behaviour of patients (positive consequences 31%, negative consequences 41%, undecided 28%).
When asked about the specific effects on the doctor–patient relationship of patients increasingly obtaining health-related information from the internet, the majority of respondents observe that online research has considerable potential for confusion and uncertainty in their patients (cf. Table
1). This can lead to nervousness or to incorrect expectations on the part of the patient, owing to erroneous or contradictory statements, to a deterioration in compliance or even to an increasing willingness to self-medicate. Only a small proportion of respondents believe that regular searching on the internet could result in patients being better informed and having a deeper insight into medical diagnoses and procedures.
Table 1
The relationship between doctor and patient can change if patients increasingly or even regularly obtain information on health and disease topics from the internet. From your opinion or experience, which of the following points are correct? (Multiple selections were possible; N = 2.532)
Patients become more nervous, more anxious | 76% |
Patients ask more questions | 72% |
Patients are more critical of the doctor | 66% |
Patients come to the office with the wrong expectations | 61% |
Patients check the doctor’s information, advice and diagnosis through internet research | 49% |
Internet research worsens patient compliance | 45% |
Patients tend to self-medicate | 40% |
Patients come to the office more often | 38% |
Patients are more willing to start conflicts with the doctor | 36% |
Patients have less trust in doctors | 35% |
Patients are better informed and can understand the doctor better | 32% |
Patients come to the doctor’s consultation hours in good time if they have complaints | 17% |
Patients avoid doctor visits more often | 15% |
Patients do not go to the doctor in time due to frequent internet searches | 11% |
Patients feel safer due to internet research | 9% |
Patients act more rationally due to regular internet research | 7% |
Characteristics of patients who conduct research online
Of the GPs respondents, 69% estimate that 15% or more of their own patients frequently or have ever come to them with the results of their own internet searches (up to 10%: 25%). The researched information mainly concerns specific disease patterns (93%) or symptoms (88%), treatments (69%), diagnoses (57%) and new medications (45%).
In the experience of the respondents, the patients who undertake extensive research on the internet are mainly people under the age of 60 (84%); 45% name (previous) psychosomatic conditions as further attributes; 37% believe these are generally people with a higher level of education.
The respondents are familiar with the phenomenon that patients could be extremely worried or scared as a result of previous online research and consequently fear that they have a serious or even fatal illness, despite the fact that there are no corresponding indications from a medical perspective. As such, three quarters of all doctors state that they have already noticed such unfounded fear of serious illnesses based on acceptance of internet content either frequently (23%) or occasionally (51%) (rarely 24%). Moreover, 47% were of the opinion that such extreme forms of internet-related health concerns increased in the course of the COVID-19 pandemic either significantly (21%) or somewhat (26%). By their own admission, 20% have experienced patient care being terminated by the patient or by the GP because the patient’s behavior was so strongly affected by information from the internet that continued care was no longer possible.
As another item set confirms, 77% of respondents perceive patients who are extremely worried or scared as a result of internet research to be an increasing problem in everyday practice. Accompanying this, in the experience of 83% of doctors, is the fact that such patients tend to demand further instrumental diagnostics.
The concluding complex of the survey covers medical coping strategies and approaches to counter internet-related health concerns. Of the respondents, 39% say that they generally ask certain patient groups to what extent they have undertaken preliminary research on the internet before visiting the doctor; 23% state that they take this preliminary internet research into account very strongly or fairly strongly in the doctor–patient discussion. Furthermore, according to 46% of respondents, they frequently or occasionally recommend websites that they consider to be reputable and reliable sources of health-related information for patients.
GPs prefer certain approaches to help patients who are worried or scared as a result of internet research. As such, many doctors continue primarily to rely on a detailed explanation of the diagnosis and treatment; if necessary, they allow a longer consultation time (cf. Table
2). Most also consider it advisable to mention reputable health information on the internet or to hand out brochures with background information. By contrast, very few GPs consider it appropriate or practical to advise patients fundamentally against searching for information on the internet on their own initiative.
Table 2
In the case of patients whose overall psychological situation could be negatively influenced by internet research, the family physician can take certain measures to counteract the emergence of health anxieties. Which of the following points do you consider promising and practicable? (Multiple selections were possible; N = 2.532)
Detailed explanation, e.g. on diagnosis and therapy, to prevent the patient from excessive or aimless internet research (if necessary, granting more consultation time) | 65% |
Joint discussion of the information or websites researched by the patient | 55% |
Handing out trustworthy information material (e.g. brochures) | 54% |
Extension of the typical anamnesis questionnaire to include the frequency of internet research on health and disease topics by the patient, so that the doctor can become aware of existing or emerging health anxieties at an early stage | 45% |
Basic discussion of the potential and risks of online research as part of the consultation | 43% |
Review of the information researched by the patient and consultation with the patient (e.g. for correction) | 41% |
In principle, advise patients not to search for information on the internet on their own initiative | 18% |