1

Dr. Google, Friend or Foe?

Written by Natasha Burgert MD

Two articles recently caught my eye while I was spending some time on Twitter. First, an op-ed piece was published on Time.com discussing how patients and doctors perceive the use of the online health information. The article was closely followed by the results of a recent PEW research study which stated that 80% of Americans used the internet to “prepare for or recover from” their doctor visit.

The results of the PEW study were less than surprising to me. Everyday I have a concerned mom or anxious dad refer to something they have read online.

Everyday.

And, everyday I get to learn about new articles and websites that are claiming to have reputable health information. I learn from my families who bring in articles and links, and often share the good information with other families who may be struggling with the same concerns.

As a medical doctor who regularly navigates the web, however, I did not expect nor appreciate the author’s tone in the Time.com piece. I was made to feel that all doctors were like lazy cattle, being poked with an electric switch towards a glowing computer screen.

I find that troubling as a practicing pediatrician. Although doctors have traditionally been thought of as “late-adopters,” not all of us fit that archaic mold. There are many, many doctors who are embracing e-communication of all types within their daily medical practice. And all successful doctors practice “shared clinical decision-making” with their families, regardless if the internet is a piece of the information puzzle.

How can you discuss online health information with your physician, without being labeled a “cyberchondriac?”

Here are some things to consider before you approach your provider with some internet research of your own.

Critique what you find

Commercial advertisers and agenda-based groups can be very deceiving online. Does the information have sources to original, peer-reviewed medical articles?

Who is writing the article, and what are their credentials? Who is paying for the study to be completed? Are there a lot of banner ads, or references to a certain brand of product? Does the writer of the article have financial interest in the items they recommend? Dr. Meisel did state this well, saying,

Many patients are going to discover the best online health information way before their doctors do. They, too, have a responsibility: patients will need to signal to their doctor how they conducted their search in a way that was smart, directed and grounded in evidence. Only then will the Google stack be recognized and used in a helpful, not counterproductive, fashion.

My favorite public sites for health information include:

  • Is your child sick? This feature is on our practice’s website to give families some information about common childhood symptoms. The site also give some guidance about what symptoms are concerning enough to contact the on-call physician.
  • www.uptodate.com This is a very well-designed site providing general information on health conditions and their treatments.
  • www.healthychildren.org A website full of childhood health information developed by the American Academy of Pediatrics.
  • www.cdc.gov General information on illness, vaccines, and travel concerns.
  • www.vaccine.chop.edu Complete, concise vaccine information.

If your provider allows, send links and articles to your doctor before the visit

Bring a list of keywords that you searched. This allows your doctor to look over the information more critically, and hopefully more thoughtfully. If your doctor does not allow you to provide information prior to your appointment, don’t expect organized discussion about your findings in a brief appointment slot. Thinking about online information critically is a time-consuming process. Give your provider ample time to look over the information after your appointment.

Be prepared for a “no”

It may be possible, that despite your best efforts, keywords or articles you have found may have been misleading. If your physician disagrees with some online information you have found, it is very appropriate to ask, “Why?” Your provider should explain why the information may not be relevant or appropriate for your specific situation, hopefully providing alternate online references to help continue your search.

We are partners

Bring information to your provider with an attitude of partnership and shared decision-making. No one likes a confrontation. Navigating health online information is a learning process for all of us. If we don’t listen to each other, we don’t learn.

If patients and doctors can have open dialog about information found online – good and bad – we can take care of patients better. And that is more than Dr. Google could ever do alone.

Dr. Burgert is a pediatrician. She works at Pediatrics Associates in Kansas City, MO .  She is a distance runner and enjoys road races around the city. She also has a passion for travel that will certainly lead to many memorable family vacations with her husband and two children. And, of course, she bleeds Husker red. Dr. Burgert regularly blogs at kckidsdoc.com

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2

We can take care of patients better. And that is more than Dr. Google could ever do alone

Written by Natasha Burgert MD

Two articles recently caught my eye while I was spending some time on Twitter. First, an op-ed piece was published on Time.com discussing how patients and doctors perceive the use of the online health information. The article was closely followed by the results of a recent PEW research study which stated that 80% of Americans used the internet to “prepare for or recover from” their doctor visit.

The results of the PEW study were less than surprising to me. Everyday I have a concerned mom or anxious dad refer to something they have read online.

Everyday.

And, everyday I get to learn about new articles and websites that are claiming to have reputable health information. I learn from my families who bring in articles and links, and often share the good information with other families who may be struggling with the same concerns.

As a medical doctor who regularly navigates the web, however, I did not expect nor appreciate the author’s tone in the Time.com piece. I was made to feel that all doctors were like lazy cattle, being poked with an electric switch towards a glowing computer screen. I find that troubling as a practicing pediatrician. Although doctors have traditionally been thought of as “late-adopters,” not all of us fit that archaic mold. There are many, many doctors who are embracing e-communication of all types within their daily medical practice. And all successful doctors practice “shared clinical decision-making” with their families, regardless if the internet is a piece of the information puzzle.

How can you discuss online health information with your physician, without being labeled a “cyberchondriac?”

Here are some things to consider before you approach your provider with some internet research of your own.

Critique what you find.

Commercial advertisers and agenda-based groups can be very deceiving online. Does the information have sources to original, peer-reviewed medical articles? Who is writing the article, and what are their credentials? Who is paying for the study to be completed? Are there a lot of banner ads, or references to a certain brand of product? Does the writer of the article have financial interest in the items they recommend? Dr. Meisel did state this well, saying,

Many patients are going to discover the best online health information way before their doctors do. They, too, have a responsibility: patients will need to signal to their doctor how they conducted their search in a way that was smart, directed and grounded in evidence. Only then will the Google stack be recognized and used in a helpful, not counterproductive, fashion.

To get you started, a few of my favorite public sites for health information include:

  • Is your child sick? This feature is on our practice’s website to give families some information about common childhood symptoms. The site also give some guidance about what symptoms are concerning enough to contact the on-call physician.
  • http://www.uptodate.com This is a very well-designed site providing general information on health conditions and their treatments.
  • http://www.healthychildren.org A website full of childhood health information developed by the American Academy of Pediatrics.
  • http://www.cdc.gov General information on illness, vaccines, and travel concerns.
  • http://www.vaccine.chop.edu Complete, concise vaccine information.

If your provider allows, send links and articles to your doctor before the visit. Bring a list of keywords that you searched. This allows your doctor to look over the information more critically, and hopefully more thoughtfully. If your doctor does not allow you to provide information prior to your appointment, don’t expect organized discussion about your findings in a brief appointment slot. Thinking about online information critically is a time-consuming process. Give your provider ample time to look over the information after your appointment.

Be prepared for a “no.”

It may be possible, that despite your best efforts, keywords or articles you have found may have been misleading. If your physician disagrees with some online information you have found, it is very appropriate to ask, “Why?” Your provider should explain why the information may not be relevant or appropriate for your specific situation, hopefully providing alternate online references to help continue your search.

We are partners.

Bring information to your provider with an attitude of partnership and shared decision-making. No one likes a confrontation. Navigating health online information is a learning process for all of us. If we don’t listen to each other, we don’t learn.

If patients and doctors can have open dialog about information found online – good and bad – we can take care of patients better. And that is more than Dr. Google could ever do alone.

Dr. Burgert is a pediatrician. She works at Pediatrics Associates in Kansas City, MO .  She is a distance runner and enjoys road races around the city. She also has a passion for travel that will certainly lead to many memorable family vacations with her husband and two children. And, of course, she bleeds Husker red. Dr. Burgert regularly blogs at kckidsdoc.com

5

Do Parents and Pediatricians Need to Reconsider How Children Use Technology?

By Brandon Betancourt

Dr. Claire McCarthy from  Children’s Hospital of Boston published a very interesting blog post regarding the need for “parents” and “pediatricians” to reconsider the way we approach modern technology with our children.

Coincidentally, my wife (a pediatrician) and I (not a pediatrician) discussed a similar issue just this morning. We were discussing how much time we should allow our 12 year-old daughter to spend texting with her friends.

I suggested we should not be too concerned with how much time she spends texting (as long as it doesn’t interfere with her responsibilities) because it is now the way children communicate. It is their thing now, just like it may have been previous generations thing to spend hours and hours in front of a TV screen or another generation’s thing to spend hours and hours talking on the telephone. As a pediatrician, my wife wasn’t convinced with my point of view.

Dr. McCarthy acknowledges that pediatricians frown upon “screen” time. She says:

We stress the 2-hour limit to help prevent obesity. We warn about Facebook depression, exposure to violence and sex, cyberbullying and online predators. We talk about how texting can keep kids up at night and how video games can contribute to ADHD.

And although she continues to support this message, Dr. McCarthy says that when we just focus on the negative, parents and pediatricians may miss two important points which are: technology is not ALL bad and, as she puts it, for better or worse, digital media is here to stay.

If we are just negative, we may miss the opportunity to inform the discussion. Pediatricians may miss the opportunity to guide children and families in the best uses of technology. Someone else will step in and do it, someone who doesn’t understand child health and development the way pediatricians do. And kids aren’t going to want to talk to their parents about what they are doing online if they think that their parents’ only response will be disapproval.

I like Dr. McCarthy’s call. She is challenging pediatricians (and parents as well), “to meet kids where they are” and start becoming more connected their world.

It’s hard to inform a discussion about something you don’t know about. So pediatricians and parents should explore the Web and see what’s out there. Do health searches; see what pops up. Find sites and applications that you like and can recommend. Talk to kids about how they use technology—learn from them. Check out Facebook and Twitter and YouTube. Consider using social media yourself.

To read Dr. Claire McCarthy’s post, you may click here 

As a pediatrician, do you think McCarthy has a point? Is there anything you’d disagree with? What about as parents? How are you dealing with “screen time?” Do you tend to have a more conservative view, like my wife, or are you more like me? We’d love to hear your thoughts.

Brandon Betancourt is medical practice administrator. He lives in the western suburbs of Chicago, has three children and admits to being addicted to his iPhone. Brandon regularly blogs at PediatricInc.com. You can follow him on Twitter @pediatricinc.