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Medicine Privacy The Internet

The Other Exam Room: When Doctors 'Google' Their Patients 231

Posted by Soulskill
from the like-dr.-house-but-lazier dept.
theodp writes "Writing in the NY Times, Dr. Haider Javed Warraich shares a dirty little medical secret: doctors do 'Google' their patients, and the practice is likely to only become more common. And while he personally feels the practice should be restricted to situations where there's a genuine safety issue, an anecdote Warraich shares illustrates how patient search could provide insight into what otherwise might be unsolved mysteries — or lead to a snap misdiagnosis: 'I was once taking care of a frail, older patient who came to the hospital feeling very short of breath. It wasn't 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 didn't 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 patient's 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 patient's privacy. I resumed our medical exam, without bringing up the finding on the Internet, and her subsequent hospital course was uneventful.'"
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The Other Exam Room: When Doctors 'Google' Their Patients

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  • by Anonymous Coward on Wednesday January 08, 2014 @08:30AM (#45896927)
    You know what a good thing is? Paragraphs, dude. Paragraphs.
  • by Vitriol+Angst (458300) on Wednesday January 08, 2014 @08:41AM (#45896979)

    So, essentially, Dr. Haider Javed Warraichis is suggesting patients to lie, because doctors are more prone to misdiagnose if they have more information?

    See what I read is that the Doctor was sharing a mistake they made with a snap judgement, based on getting MORE INFORMATION -- but out of context. I think our take-away could be; "If you are going to use this internet-based information, take it with a grain of salt and find some context." There's nothing about lying, that I'm reading.

    It's a good thing he didn't ask her if her parents were embarrassed about her drunken sexy behavior on spring break.

    FTA;

    To me, the only legitimate reason to search for a patient’s 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.

    That to me means; "limit your searches to investigate psychosis or abuse, and double-check conclusions."

  • Re:Patients Lie (Score:3, Informative)

    by gweihir (88907) on Wednesday January 08, 2014 @09:13AM (#45897205)

    Only if the doctors and nurses are incompetent. Unless they are sure, they have to assume HIV and the like anyways and be careful.

  • Re:So.... (Score:5, Informative)

    by gstoddart (321705) on Wednesday January 08, 2014 @09:55AM (#45897545) Homepage

    Next bit of news: Doctors offices use VPN's and Tor to access Google.

    Bullcrap. Even if doctors all had the technical sophistication to do this, which I assure you, they don't -- if you can identify the IP address of the VPN (or some of the TOR exit nodes) then you can still determine that 'a' doctor, and possibly 'this group of doctors' is doing searches about people.

    When I see this:

    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 patient's face, with details about how she had been detained for cocaine possession more than three decades earlier.

    I immediately think, "yup, the, the nurses are just googling and finding everything about you, and they're probably doing it with zero anonymity". My impression of the standards of IT and security in the average medical context is that it's barely there (if at all), managed by people who don't know or care, likely woefully out of date and missing security updates, and probably on a network which has been compromised by malware.

    Sorry, but the interwebs pretty much guarantee that unless you took some pretty extraordinary measures, determining that a specific doctors office had the mugshots.com up for a patient isn't all that tough, which tells you that patient is associated with that doctor.

    I do not believe the average doctor's office has the technical skills, resources, or inclination to be able to do this in a way which would be safe, stay within HIPAA laws, and guarantee you aren't leaking out patient information in the process.

    Which means they have no business doing it in the first place, but being doctors, think they know everything and have no idea of the ramifications of this.

  • by mjwx (966435) on Wednesday January 08, 2014 @11:15AM (#45898311)

    So, essentially, Dr. Haider Javed Warraichis is suggesting patients to lie, because doctors are more prone to misdiagnose if they have more information?

    Erm... because doctors would never make a misdiagnosis based on wrong information.

    Has Dr. Javed Warraichis been self prescribing a wee bit too much?

    One of the big reasons doctors (or anyone) turns to other sources of information beyond the horses mouth is because the horse fucking lies.

    Those of us who've survived their time in tech support know that what the user tells you is never to be trusted. The same is true for patents. The big difference is that doctors dont have the luxury of finding out what is actually wrong from another source. So they have to rely on their intuition, external observation and the ability to tell what someone isn't saying.

    I'm willing to bet that in the case of 95%+ of all misdiagnosis the cause was the patient either didn't tell the doctor what was actually wrong or worse, lied about it.

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