I recently read an article in NYTimes titled “When Doctors ‘Google’ Their Patients”, which details one physician’s thoughts on whether or not doctors should look up their patients on the internet. What struck me was the fact that despite growing up with the Internet and being able to find information about practically anyone using Facebook, LinkedIn, Google, or Instagram, I have never once been tempted to find out more about my patients online. For me, our relationship was one that was contained within the confines of the hospital, and I never thought to “double check” on anyone’s history after the initial patient interview. But this article made me think, are there circumstances in which I should Google my patients, to better patient care?
The most obvious cases I can think of for Googling patients are one in which the doc suspects that the patient is lying to abuse the healthcare system. Malingering is intentionally faking illness for secondary gain, whether it is to get time off work, narcotics, disability insurance, avoiding jailtime, etc. The NYTimes article author shared a story of an elderly female patient he took care of whose drug screen came back positive for cocaine. She denied drug use, but then a quick internet search revealed that she had been detained for cocaine possession decades earlier. The author doesn’t go into specifics but I imagine this could change how he approaches the patient’s narcotics regimen or how he speaks to her about drug cessation. Then there are those with factitious disorder, where patients fake being sick in order to play the patient role. I have heard stories about patients who secretly ingest feces in the hospital, inject themselves with insulin, contaminate their central lines, or intentionally cut themselves in order to stay in the hospital and get treated for self-inflicted injuries. These red flags should be in the medical record, but sometimes these patients are not easy to track down and it is painfully hard to get outside hospital records depending on where you work. A recent news story uncovered a man in Washington who faked work injuries under multiple names and social security numbers to repeatedly obtain Vicodin, Percocet, and other powerful painkillers.
A field that I think Googling patients can sometimes be helpful in is psychiatry. In some of these patients, an accurate history is difficult to obtain, and if someone has an extensive history of suicide attempts, there may be more than meets the eye. The internet may uncover additional information that may add to the story behind the complex psychiatric pathology that the patient suffers from.
This is a slippery slope though, because I can also foresee instances in which a physician uncovers something he or she doesn’t like or has an implicit bias against in a patient. In these cases, what the physician discovers on the internet may alter his attitudes towards the patients and even negatively affect patient care. (Although physicians everywhere, especially at county hospitals, do take care of patients in jail, and what I’ve been taught is to not ask about the crime(s) committed) I think it is important in today’s day and age, with technology so accessible and so very revealing, for physicians to remember to treat patients to the best of their ability.
All in all, I think physicians should be wise in choosing to look towards the Internet for more background information on patients. If a doctor suspects something fishy is going on, or that medical care is being hindered by lack of information, then perhaps it isn’t such a bad idea to ask Google for a few more details.