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Research

The effect of Dr Google on doctor–patient encounters in primary care: a quantitative, observational, cross-sectional study

Noor Van Riel, Koen Auwerx, Pieterjan Debbaut, Sanne Van Hees and Birgitte Schoenmakers
BJGP Open 2017; 1 (2): bjgpopen17X100833. DOI: https://doi.org/10.3399/bjgpopen17X100833
Noor Van Riel
1 GP and Researcher, Public Health and Primary Care, University of Leuven, , Belgium
MD
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Koen Auwerx
2 GP and Researcher, Public Health and Primary Care, University of Leuven, , Belgium
MD
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Pieterjan Debbaut
3 GP and Researcher, Public Health and Primary Care, University of Leuven, , Belgium
MD
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Sanne Van Hees
4 GP and Researcher, Public Health and Primary Care, University of Leuven, , Belgium
MD
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Birgitte Schoenmakers
5 GP and Professor of General Practice, Public Health and Primary Care, University of Leuven, , Belgium
MD, PhD
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  • For correspondence: Birgitte.schoenmakers@kuleuven.be
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Article Figures & Data

Tables

    • View popup
    Table 1. Population characteristics
    Variable (n = 718)n%
    Sex
     Male
     Female

    238
    480

    33.15
    66.85
    Age
     Mean age, years (SD)
     18–25
     26–35
     36–45
     46–60
     61–75
    40

    201
    123
    122
    182
    90
    (15)

    27.99
    17.13
    16.99
    25.35
    12.53 
    Education level
     Primary school
     Middle school
     High school
     College
     Professional

    7
    59
    203
    241
    208

    0.97
    8.22
    28.27
    33.57
    28.97
    Frequency of internet use
     Monthly
     Weekly
     Daily
     More than once a day

    1
    18
    237
    462

    0.14
    2.51
    33.01
    64.35
    Frequency of internet use to gather health information
     Usually not
     Usually
     Always

    308
    323
    87

    42.90
    44.99
    12.12
    Frequency of GP consultations
     Never
     Less than once a year
     One to several times a year
     Monthly
     More than once a month

    15
    152
    512
    36
    3

    2.09
    21.17
    71.31
    5.01
    0.42
    • Note: Some variables may not add to 100% due to of rounding.

    • View popup
    Table 2. Responders’ answers to the statements: 'After my online search to gather health information …'
    StatementsNeverUsually notUsuallyAlways
    n (%)n (%)n (%)n (%)
    I go to the GP (n = 630)61 (9.68)211 (33.49)288 (45.71)70 (11.11)
    I do not go to the GP although this was the original plan before the search (n = 595)248 (41.68)265 (44.54)78 (13.11)4 (0.67)
    I am more likely to visit the GP than I intended before the search (n = 603)132 (21.89)312 (51.74)144 (23.88)15 (2.49)
    I start medication without consulting a doctor (n = 661)467 (70.65)151 (22.84)40 (6.05)3 (0.45)
    I do not think I need medication although I did think this before the search (n = 546)204 (37.36)269 (49.27)70 (12.82)3 (0.55)
    I am reassured (n = 601)74 (12.31)284 (47.25)226 (37.60)17 (2.83)
    My worries about my symptoms increase (n = 634)116 (18.30)329 (51.89)174 (27.44)15 (2.37)
    I have the feeling my symptoms got worse (n = 630)254 (40.32)298 (47.30)69 (10.95)9 (1.43)
    I have the feeling my symptoms got better (n = 595)206 (34.62)314 (52.77)69 (11.60)6 (1.01)
    I notice additional complaints I did not notice before the search (n = 630)226 (35.87)299 (47.46)98 (15.56)7 (1.11)
    I have more confidence in my GP than before the search (n = 519)93 (17.92)131 (25.24)201 (38.73)94 (18.11)
    I have less confidence in my GP than before the search (n = 596)329 (55.20)239 (40.10)23 (3.86)5 (0.84)
    • Note: Some variables may not add to 100% due to rounding.

    • View popup
    Table 3. The correlation between the independent variables and the effects of online searching: multiple regression analysis.
    VariableFR2Age category, bDegree, bFrequency of internet use, bFrequency of internet use for health information, bFrequency of GP visits, b
    GP1 11.42a 0.080.07b 0.020.090.010.39a
    Not going to the GP anymore2 4.88b 0.040.030.01−0.010.18a −0.12c
    More likely to go to the GP3 3.42b 0.030.03−0.05−0.030.10c 0.11
    Self-medication without advice4 5.54a 0.04−0.010.030.090.12b −0.08
    No medication anymore5 4.72b 0.04−0.02−0.010.050.19a −0.06
    Reassurance6 4.67b 0.040.03−0.01−0.040.18a −0.09
    Increased anxiety7 9.50a 0.07−0.06b 0.0020.040.19a 0.22a
    Increased severity of symptoms1.600.01−0.02−0.010.090.050.06
    Decreased severity of symptoms9 2.76c 0.02−0.03−0.002−0.030.15b −0.01
    Additional symptoms10 4.48b 0.03−0.040.030.050.12b 0.15b
    More confidence in the GP11 1.610.020.04−0.03−0.08−0.050.10
    Less confidence in the GP12 5.31a 0.040.01−0.030.030.18a −0.02
    • ↵ b = regression coefficient. a P<0.0001. b P<0.01. a P<0.05. 

    • Statements 'After my online search for health information …':

    • ↵ 1 I go to the GP

    • ↵ 2 I do not go to the GP although this was the original plan before the search.

    • ↵ 3 I am more likely to visit the GP than I intended before the search.

    • ↵ 4 I start medication without consulting a doctor.

    • ↵ 5 I do not think I need medication although I did think this before the search.

    • ↵ 6 I am reassured.

    • ↵ 7 My worries about my symptoms increase.

    • 8 I have the feeling my symptoms got better.

    • ↵ 9 I have the feeling my symptoms got worse.

    • ↵ 10 I notice additional complaints I did not notice before the search.

    • ↵ 11 I have more confidence in my GP than before the search.

    • ↵ 12 I have less confidence in my GP than before the search.

    • View popup
    Table 4. Statements discussed with the GPs. A: statement based on the descriptive analysis of the survey’s results, B: adjusted statement based on the first four conversations with GPs
    Statement 1
    A. Most of my patients do not start self-medicating after their online search to gather health information.
    B. Most of my patients do not start self-medicating after their online search to gather health information. If they do so, they do it mainly when they have benign symptoms or on the advice of significant others.
     
    Statement 2
    A. The online search for health information does not influence the confidence of the patient in their GP.
    B. The online search for health information does not influence the confidence of the patient in their GP.
     
    Statement 3
    A. The online search for health information does not make my patients experience additional symptoms.
    B. The online search for health information does not make my patients experience additional symptoms. Some people will be more likely to do so, such as patients in their 20s and 30s and patients with tendencies toward hypochondria.
     
    Statement 4
    A. The online search for health information does not influence the severity of my patient’s symptoms.
    B. The online search for health information does not influence the severity of my patient’s symptoms.
     
    Statement 5
    A. I do not have the feeling that the online search for health information makes my patients more anxious.
    B. I do not have the feeling that the online search for health information makes my patients more anxious, although naturally anxious people often become more anxious after the search. Moreover, this is probably the group of patients that searches the most on the internet for health information.
     
    Statement 6
    A. If I know that my patient searched online to gather health information, this will complicate the consultation.
    B. If I know that my patient searched online to gather health information, this will not influence the consultation in a negative way. First of all, there is the possibility that we will come together to a broader differential diagnosis. Secondly, I can easily respond to the patient’s ideas, concerns, and expectations and patients will hesitate less to ask for specific diagnostic tests. This can lead to an interesting dialogue.
     
    Statement 7
    A. If patients tell me about the information they found on the internet, I can discuss this during the assessment and plan. For example, I can give them websites where they can find health information in the future.
    B. If patients tell me about the information they found on the internet, I will put that information in perspective. For example, I can give them websites where they can find health information in the future.
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The effect of Dr Google on doctor–patient encounters in primary care: a quantitative, observational, cross-sectional study
Noor Van Riel, Koen Auwerx, Pieterjan Debbaut, Sanne Van Hees, Birgitte Schoenmakers
BJGP Open 2017; 1 (2): bjgpopen17X100833. DOI: 10.3399/bjgpopen17X100833

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The effect of Dr Google on doctor–patient encounters in primary care: a quantitative, observational, cross-sectional study
Noor Van Riel, Koen Auwerx, Pieterjan Debbaut, Sanne Van Hees, Birgitte Schoenmakers
BJGP Open 2017; 1 (2): bjgpopen17X100833. DOI: 10.3399/bjgpopen17X100833
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Keywords

  • primary care
  • patient empowerment
  • patient education
  • Health care

More in this TOC Section

  • Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study
  • Evaluating the UK’s first national prescribing assessment for GPs in training using an online survey
  • Training primary care staff in delivering the primary care consultation remotely: a systematic review
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