Should Doctors be “Googling” Patients?

Doctor, patient

We live in a society now incredibly dependent on technology, and the internet is one of the most useful tools at our disposal. Finding health insurance is easier than ever, connecting with friends and relatives is only a social network away, and the entirety of human knowledge can be organized and accessed in mere seconds thanks to the advent of search engines like Google.

Google isn’t just good for settling trivia questions and finding recipes. It’s good for learning about the people we encounter in day-to-day life. Employers Google job applicants, people Google their newest love interest before going on that first date, and the simple fact that “Google” is commonly used as a verb is a testament to the prevalence of this practice in modern culture. It’s understandable that doctors may feel the urge to Google their patients to learn more about the factors that may affect their health, but is this an innocent way to research a patient or a gross invasion of a patient’s privacy?

The authors of “Navigating the Google Blind Spot: An Emerging Need for Professional Guidelines to Address Patient-Targeted Googling” hope to spur discussion on this topic, and propose, in their paper, 10 guidelines to help doctors decide whether or not it is ethical to Google a patient. The authors express that they believe there are situations in which it is appropriate to do an online search for additional information on a patient, but that in the vast majority of situations, this behavior is unacceptable. The paper hopes to spark conversation about the matter and possibly encourage the American medical Association to address the practice with more official guidelines.

The ten situations that the paper describe as justification to Google a patient are…

1. If a physician has a duty to immediately warn a patient of future harm
2. Detect if a patient is “doctor shopping” – visiting multiple physicians looking for an unneeded treatment
3. Evasive responses to standard clinical questions, hiding crucial information
4. Patient claims extremely improbably family history of illnesses
5. Discrepancies between a patient’s verbal accounts and clinical documentation
6. Undue level of urgency or aggressiveness is displayed
7. Reliable information that a patient is lying or otherwise omitting information
8. Inconsistencies between the stories of patients and family members
9. Suspicions regarding substance abuse or physical mistreatment
10. Reasonable suspicion that a patient is suicidal

While these guidelines paint a reasonable picture of several situations that might call for further investigation, but it’s still a grey area in the medical community. Is this an invasion of patients’ privacy? Could Google searches save lives and prevent innocent families from making a life insurance claim? Is it a physician’s duty to invade a person’s privacy to save their life? The paper offers two situations to consider.

In the first situation, a 26-yearl-old woman was going from doctor to doctor requesting that both of her breasts be removed to eliminate the risk of developing breast cancer. The patient in question had not undergone genetic testing or proven in any way that she was at risk, and refused to do so. She also presented an “almost unbelievable” family history of multiple varieties of cancer, including breast cancer, so her genetic counselor Googled her. The Google search revealed that the patient was appearing at conferences, blogging, and giving newspaper interviews about how she was a cancer survivor – despite the fact that she wasn’t – and raising money to visit a conference under fraudulent pretenses. This information prevented the surgeon from performing this invasive and utterly unnecessary surgery, possibly saving the life of the patient. It seems that the patient wasn’t just gathering and comparing free health quotes – she was trying to find a doctor who would perform a dangerous and unneeded procedure.

On the other end of the spectrum, another case was provided presenting a situation in which a Google search may simply undermine the trust that must be held between a patient and their physician. A patient went to their doctor seeking help in pursuing a healthier lifestyle. The patient wanted to quit smoking, eat healthier, and exercise, and he wanted his doctor to help him do so. The doctor then Googled the patient and found a picture of them smoking a cigar taken after the healthier lifestyle was supposedly adopted. What should the doctor do in a situation like that?

The American Medical Association has a stance on how technology should be used, but the act of Googling a patient still lies within a grey area. What do you think? Should doctors be allowed to Google their patients at all? Should it be limited to special circumstances or disallowed completely? Share your perspective in the comments section below!