Getting to know a person...before getting to know a person.
I recently read this article below about physicians having the 'urge' to google their patients, perhaps to find out some background history..or perhaps to just satisfy the curiosity of the human mind. At first I thought, wait...this goes against all the rules and regulations of HIPPA ..and then i thought..wait..this shouldn't be a protocol they routinely do with every patient..and then i thought..wait..isn't this what physicians already do? Upon entering an exam room, a physician has to chart a couple things about the patient. Physical examination and chief complaint are among the few things asked and reviewed, but the one burning question is...what's your family history/your history? As a patient, and even as a person, you have every right to say what you want and do not want about who you are and where you come from.Â
However, with technology booming over the years, it has increasingly become easier to find out information about individuals. A simple google search of the first and last name will give you at least once piece of evidence readily available for the world to read or view. But who's fault is it really....the individual who has an option to put out their personal lives online, or the physician inquiring about the patient who had to resort to internet search engines?
I think the article below makes a valid point. Even with technology having it's peak over the course of years, standard and practical protocols should still be instilled within physician-patient interaction. Not only does this 'ideology' go along in the medical field, but also in our interactions with people in our modern day of events.Â
I myself am guilty of wanting to get to know a person...BEFORE EVEN GETTING TO KNOW A PERSON! "Does he/she have a facebook? LinkedIn? Twitter? Instagram?" Â Ultimately that's the downfall of it all because we're not allowing ourselves to build personal relationships with people. If we "get to know a person before getting to know a person", we have created a overly astute image in our minds about what kind of person somebody is, solely based on pictures, events they have attended, the way they dress, what music they listen to, etc. And when we actually meet the person, we go in having a preconceived idea of who the person is without even exchanging words! It's a problem in and among itself, and i don't see anyone over analyzing it like i do myself, but hey someone has to address the elephant in the room.Â
So after realizing how much our generation has quickly acclimated to this online lifestyle without even knowing it, I took it upon myself to TRY get to know individuals based on their communication skills and what they WANT to tell me. Sounds like something that we should already be doing right? Completely...yes, but you'd be surprise how this simple act of getting to know someone in person has quickly drew a negative correlation graph. Yes, I have instagram and facebook apps on my iphone that would allow me to creep on a person, but then that would just mean i'm creating my "own" criteria for certain people I want to meet, which is not the case. Everyone has a different story and background, and I think utilizing the internet would completely diminish the whole experience of allowing someone to say what they want to say about themselves.
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Anyway, here's the article:
I remember when I first looked up a patient on Google. It was my last day on the bone marrow transplant unit, back when I was an intern. As I stood before the patient, taking her history, she told me she had been a painter and suggested I look up her work on the Internet. I did, and I found her paintings fascinating. Even though our paths crossed fleetingly, she is one of the few patients I vividly remember from that time.
Google has taught me other things, too, things that donât come up during the routine history-taking or medication checks of my usual doctor-patient interactions. I learned recently, for example, that one of my patients had been an Olympic gold medalist and world-record holder in the 1960s. Knowing more about my patients as people helps build empathy.
Doctors do âGoogleâ their patients. In fact, the vast majority of physicians I know have done so. To my generation, using a search engine like Google comes as naturally as sharing pictures of our children or a recent vacation on a social networking site like Facebook. But it surprises me that more physicians donât pause and think about what it means for the patient-doctor relationship.
What if one finds something that is not warm and fuzzy? I recently read about a case in which a 26-year-old woman went to a surgeon wanting to have a prophylactic double mastectomy, citing an extensive history of cancer in her family. However, she was not willing to undergo any work-up, and her medical team noted several inconsistencies in her story. When they searched online, it turned out she had set up multiple Facebook accounts soliciting donations for malignancies she never had. One page showed her with her head shaved, as if she had already undergone chemotherapy. The surgeons immediately decided to halt her care.
I was once taking care of a frail, older patient who came to the hospital feeling very short of breath. It wasnât immediately clear why, but her breathing was getting worse. To look for accidental ingestions, I sent for a drug screen and, to my great surprise, it came back positive for cocaine. It didnât make sense to me, given her age and the person lying before me, and I was concerned she had been the victim of some sort of abuse. She told me she had no idea why there was cocaine in her system.
When I walked out of the room, a nurse called me over to her computer. There, on MugShots.com, was a younger version of my patientâs face, with details about how she had been detained for cocaine possession more than three decades earlier. I looked away from the screen, feeling like I had violated my patientâs privacy. I resumed our medical exam, without bringing up the finding on the Internet, and her subsequent hospital course was uneventful.
I am tempted to prescribe that physicians should never look online for information about their patients, though I think the practice will become only more common, given doctorsâ â and all of our â growing dependence on technology. The more important question health care providers need to ask themselves is why we would like to.
To me, the only legitimate reason to search for a patientâs online footprint is if there is a safety issue. If, for example, a patient appears to be manic or psychotic, it might be useful to investigate whether certain claims the patient makes are true. Or, if a doctor suspects a pediatric patient is being abused, it might make sense to look for evidence online. Physicians have also investigated patients on the web if they were concerned about suicide risk, or needed to contact the family of an unresponsive patient. In my state, Massachusetts, doctors can also use a specialized database to track every pharmacy a patient took controlled drugs from â an especially useful tool when drug abuse is suspected. But if the only reason a doctor searches online is to gather personal information that patients donât want to share with their physicians, then it is absolutely the wrong thing to do.
Recently, one of my primary care patients was back in clinic, with some worrisome news. In spite of increasing the dose of his medication, his panic attacks were getting worse. He had told me that as he saw his business success grow, so did his stress, and the frequency of his panic attacks.
I stepped out of the clinic to speak with my supervising physician. I related the patientâs history, telling him about the growing success of the patientâs business.
âWhat sort of business?â he asked. When I told him that I had forgotten to ask, he quickly flipped the window on the computer before us from an electronic medical record to Google and typed in the patientâs name.
But before he pressed return, he paused.
This was unusual â most doctors I know donât pause. Then, with the cursor blinking before us, he pressed the backspace key, keeping it pinned until there were no more letters for the cursor to gobble up. And he proceeded to do what has worked for physicians for eons. He sat down next to the patient and asked.
http://well.blogs.nytimes.com/2014/01/06/when-doctors-google-their-patients-2/?_r=0
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