'Problem' Patients: Beware the 'Cyberchondriac'

This is the second in a four-part series exploring better communications with your patients to enhance their visits to your practice. Scroll down to access the first part, on dealing with the waiting game. Trisha Torrey will also participate in a live question and answer session - more information here.

Last week, we looked at the problem of patients who complain about waiting room times. There may be very little you can do to improve the amount of time patients wait for you, but what you can do is make them feel a bit more in control of that time by telling them what to expect, thereby giving them a better feeling of control over that time.

Waiting room times are one thing, but what about the "Googlers"?

In your perfect world, you may prefer your patients not be looking for medical information online. They can’t evaluate it themselves. Much of it is wrong and dangerous. Your schedule doesn’t allow for long conversations. It would just be better if they forgot about the Web, and relied on you.

However, simply stated, your patients are going online whether you want them to or not. They are looking up every twinge, sniffly nose, and pain on the web, and you can’t stop them. The patient-Googling train has left the station.

Not only that, they have probably diagnosed themselves, or at least have a good idea of what their medical problem is, even before they dialed the phone to make an appointment with you. You may be the first doctor they see, but you may be providing a second opinion.

You can’t beat Dr. Google, so you might as well join him. And the way to do that, just like improving your patients’ waiting room frustrations, is to manage your patients’ expectations.

So how do you handle the patient who brings along a stack of print-outs of information he found online?

The most important piece of advice is to not be dismissive. Your patient is feeling empowered because he spent time learning about his symptoms, brushing up on the lexicon, understanding anatomy, whatever it took to try to evaluate the problems he is having. Dismissing his efforts will frustrate him, may anger him, and he may become distrustful – which will then sour your entire relationship. You will either lose your patient, or he will be non-compliant – or both.

Your better approach is to do two things: allow some time, even if brief, for the conversation, and guide him toward the information you know is good and credible.

When your patient brings along a stack of printouts, or starts a sentence with “I read on the Internet…,” acknowledge his willingness and interest in learning more. Tell him you appreciate an informed patient because you’ve found that the more your patients understand, the better they are about adhering to treatment decisions, and reporting problems.

Then explain that his insurance, and your schedule, don’t allow for long conversations (might as well be candid – it builds trust), but if he could choose one point to ask about, what would it be? After you review that one point, ask him to choose one more to raise -- at your next appointment.

Then, before he leaves, give him a brochure with a list of websites you think address his particular problem, or even a slip of paper that provides a link to a place on your own website with those resources. The more targeted to that one patient’s particular problem, the better. (e.g. better to have a page full of diabetes links for a diabetes patient, then one link to WebMD for all patients.)

If you really want to help your patient, and help yourself, then teach him how to assess whether the information he finds is credible. You don’t have to do this yourself. There are many resources online that help patients avoid the snake oil, or promotional sites, or those that are just wrong. (I happen to have such a list for you.) 

By working WITH your patient on finding credible information, and managing his expectations about how he can have conversations with you about his findings, you will build trust.

The bonus? A trusting patient won’t be so apt to annoy you or make you cringe at the start of your day.

Next week, we'll take a look at when modesty and honesty can get in your way.

Trisha Torrey is "Every Patient’s Advocate," the About.com Guide to Patient Empowerment, and author of "You Bet Your Life! The 10 Mistakes Every Patient Makes (How to Fix Them to Get the Health Care You Deserve)." She focuses on helping patients and doctors work more collaboratively to improve outcomes for all.

Have a "problem" patient of your own - now or in the past? Trisha Torrey will be participating in a live question and answer session on Friday, May 13 at 12 p.m. EST to discuss her Practice Notes blogs and take your questions. The event is free, but registration is required.

E-mail keith.martin@ubm.com by Thursday, May 12 at 5 p.m. EST to get your spot for this event.