The Other Exam Room: When Doctors 'Google' Their Patients 231
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.'"
It's the sign of our times (Score:5, Insightful)
Patients Lie (Score:5, Insightful)
And it could kill them.
So.... (Score:5, Insightful)
... adoctor will fondle and touch and examine your most intimate body parts, yet they shouldn't look at publicly available information? STUPID.
Yes, they shouldn't jump to conclusions based on what they find, but otherwise, fair game.
It's only fair (Score:3, Insightful)
After all patients google the doctors too.
Re:"feeling like I had violated my patient's priva (Score:5, Insightful)
It's public info, and it could help the doc make a decision, so let them use it.
BUT, make them spell out the patient what data they used to make their diagnosis if it was not provided directly by the patient.
Re:What surprises me is that... (Score:5, Insightful)
Re:It's the sign of our times (Score:5, Insightful)
Google is like a knife: neither inherently good nor inherently evil.
Some people will do the equivalent of SEO and actually create lies about themselves that people will find. Literally, if you're smart about it when people google your name all they will see is that you are some sort of awesome human being. Link to press releases of you donating a kidney to some poor schmuck who couldn't afford it. Link to how Jesus washed your feet. Link to positive stuff.
Other people won't get it and the picture your ex girlfriend posted of you pissing yourself will make the front page of google.
Re:Patients Lie (Score:5, Insightful)
Patients don't lie. They just don't have a medical professional's understanding of what is and isn't important.
Re:It's the sign of our times (Score:4, Insightful)
Re:Patients Lie (Score:5, Insightful)
And yet, the doctor seems to have determined that it had nothing to do with the current stuff and moved on:
So, depending on the kinds of tests he was doing, he apparently concluded it was a red herring.
Let me give you some insight as a doctor.
Patient comes in, lies, is actually abusing cocaine. Cocaine is a stimulant, and can cause overexertion of the heart through either chronic use or acute overdose, leading to shortness of breath and weakness, which the patient came in with. Additionally, smoking cocaine and all its impurities can damage the lungs.
It had everything to do with the "current stuff", as the patient lying and abusing cocaine as an elderly person ties everything together logically. Medical mystery solved, the doctor goes about his day. Seeing gramps come into the hospital after shooting up or smoking some dope is uncommon, but not unheard of.
Now, elderly person comes in, unknown care situation at home or what passes for home. Tests positive for drugs in their system. This explains why they came in with their symptoms, but not how it got there. That possibility requires further investigation, and may be cause for a call to adult protective services.
TL,DR: Not a red herring. The doctor reacting as they did was because they got the answers they needed, not because it wasn't relevant.
Re:Hmmmm ... (Score:5, Insightful)
I am a doctor.
Wouldn't doctors googling their patients essentially violate HIPAA rules?
No.
Because you've now let the fact that you are a doctor treating a specific patient bleed out around the corners, and since Google is keeping track of who you are and what you searched for, they know it too.
Unless you are doing this in such a way that you can guarantee you're not causing patient confidentiality to be breached (which Google sure as hell isn't), I'm of the opinion you've demonstrated a lapse in ethics, and a breech of the law.
Violating HIPAA takes intent. And you're taking the doctor's responsibility to protect patient information way too far.
For example, Doctor X discusses Patient Y's case with Friend Z, with specific identifying information. HIPAA violation.
Doctor X discusses Patient Y's case with consulting Doctor A in a suitably private conversation over the telephone. Unknown to the parties, the NSA / and/or the phone company is wiretapping the line, and just learned all about Patient Y. Not a HIPAA violation on either Doctor's part. Doctors have to take reasonable precautions to protect their patient's privacy. Guarding against every possible outlet that snooping intelligence agencies and snooping internet companies could use is too much, and we'd never get anything productive done.
And, even if you search in a manner you know was anonymous, if those searches come from something which is identifiable as being the anonymous search of doctors, the content of those searches can still leak information out.
Because when Google see that Dr. Joe Quack has searched for Bob Skippy Smith followed by a quick refresher on the symptoms of herpes .... Google knows (or can infer) that Bob Smith has Herpes.
Doctors are not information theorists, and quite possibly not well educated enough about this technology to be using it in conjunction with their medical practice. Because clearly, if they understood this a little better, they'd realize they've more or less violated their ethics (and possibly the law) by doing this.
Doctors Googling their patients is a terrible idea, and has every possibility of violating the privacy of the patient, as well as the laws meant to protect it.
This would be an incredibly bad idea on Google's part to try to gather accurate information this way on patients. Because I assure you, doctors are neither linear nor subject related in their internet searching. Just because I google "gstoddart" and then a few minutes later "UpToDate: complications of inserting foreign objects in anus" does not mean the two are anywhere related, despite what you're thinking. I may have 20 different patients on my service at any given time, and I frequently have to be thinking about multiple cases at any given time during a workday. Hell, just to make things more confusing for google, maybe I googled "best place to order roses nearby" in between those two google searches, because I'm taking my girlfriend out to dinner after work.
Sorry, while I hate it, no one, not me, not you, has privacy anymore online or electronically. While we can fight against it, get used to it.
Re:A snap misdiagnosis (Score:4, Insightful)
My opinion is that doctors are busy, and they're combating declining profits by pipelining more patients. If a doctor googled me I'd be shocked that he found the time or interest. I'm not sure I could consider it a breach of privacy...if it's on google it's hardly private, no matter what I may personally prefer.
In the small window of time they do give me, I think think my doctor at least attempts to give my family the best care he can. He just has to restrict himself to about 15 minutes of care. Honestly given the cost of doctor visits I'd try cutting out the blow before I ever showed up, but I suppose if you could afford the drugs then the visit may not be so bad.