'Dr Google' in the patient chair

There is no escaping the fact that ‘Dr Google’ is becoming more and more influential in GP consultations. At Medical Protection, we commissioned a YouGov online survey of 2021 British adults to look at the pros and cons of seeking medical advice from the internet.

The survey, undertaken between 26-31 May this year, revealed that almost half of the public (47%) have searched online for their symptoms and / or possible diagnosis before visiting their GP.

While it is positive that patients are taking an active role in their healthcare, it can mean that a patient enters the consulting room with preconceived and firmly held views about what is wrong with them and what the treatment should be. This can be a recipe for a dysfunctional consultation and frustration for both parties, especially if the doctor does not agree with the patient’s view or decides on an alternate treatment plan. This is reflected in the fact that over one in five members of the public (21%) say they have challenged their GP’s diagnosis, and 50% agree that their GP should always give them the prescription, treatment or referral to a specialist that they request.

This of course presents challenges for GPs. When we also surveyed our members about patient expectations in May (we received 707 responses), almost 9 out of 10 respondents (86%) said that they sometimes, most of the time or always encounter challenging experiences with patients when they do not provide the prescription, treatment, or referral to a specialist they request. An example of this is the potential conflict caused by insistent patients requesting antibiotics even when they may not be necessary, or wanting referrals for treatments not usually funded by the NHS.

It is reassuring to see from the YouGov survey that the vast majority (80%) of the public believe that their GP does meet their needs and expectations. However, when expectations are not met, it can lead to patients feeling dissatisfied, a breakdown in the doctor-patient relationship and a greater risk of the patient pursuing a complaint or claim against the GP.

So what should GPs do when they feel Dr Google is also lurking in the consultation room? Clearly it is important for GPs to always try to establish exactly what their patient’s expectations are and whether they have any specific anxieties. There should also be a focus on addressing expectations throughout the consultation and involving the patient in decisions around how to manage any issues.

Where a patient has a false belief or unrealistic expectation, it should not be dismissed without a discussion and explanation of how and why an alternative option is in their best interests. These are the fundamental rules of shared decision making; a practise whereby doctors have a professional, legal and ethical obligation to involve patients in decisions around their own care.

Patients should be cautious about self-diagnosis via the internet, and during the consultation, it may also be appropriate for GPs to encourage this. They can also guide patients to useful health resources and patient group sites which may help with their ongoing healthcare.