IF YOU think your visit to the doctor stops once you leave, you could be surprised, as one in six doctors admits to searching you online. Some doctors believe the duty of care extends far beyond the practice. TELLING your doctor you have only four drinks a week when you actually love a bender might not be as clever as you think. If you openly share information about your life online, there is a good chance your doctor already knows all about it. The booze, the sun, the cigarettes, the unhealthy burgers ... everything. But why would your doctor want to search for you online? Some suggest it’s to discover the “truth” about their patients to help provide more accurate care, while others admit it’s simply curiosity, voyeurism or habit. This doesn’t necessarily mean your doctor is stalking your Instagram page, although an Australian study found one in six medical practitioners admitted to going online to look for information about a patient — on par with doctors in the US and Canada. The same amount of doctors also believe it’s OK to look up publicly available online information about a patient as part of regular clinical practice. In an emergency such as a suicide attempt, 37.8 per cent of doctors said it would appropriate to search patient information online — 35.6 per cent were neutral and 26.7 per cent disagreed. The internet brings new ethical and legal dilemmas to health care, each with vastly different outcomes. If a doctor finds a picture of a patient waiting for a liver transplant drinking alcohol, they could intervene to stop the operation. Searching online could be especially useful for ER doctors, where patients are unable to provide information due to being psychotic, intoxicated, or suicidal. Learning about patients from their digital footprints is not without limitations, given posts may not always be accurate or timely and accessing without consent could be viewed as a breach of trust. Researcher James Brown, who conducted the Australian research in 2014, said more needs to be done to develop stricter guidelines to avoid any trouble that may arise. “We found poor literacy from the Australian Medical Association and very informal guidelines, which makes it easy for the doctor to make the wrong call,” he told news.com.au. Mr Brown said as a younger generation of doctors who grew up with the internet start climbing the ranks, there will likely be more integration of social media and healthcare. “Younger doctors have grown up with online communication, and frequent personal use may have instilled confidence in their ability to navigate any potentially hazardous ethical dilemmas,” he said. “In comparison, older doctors have not been as involved in the progressive integration of social media into daily life, nor the increasing volume of its use.” Googling patients might be helpful in the ER, but maybe not in all cases. A journal article by University of Washington clinical psychologist Keren Lehavot explored a case of a man in his late 20s being forcibly brought to hospital by police after updating his profile picture on Facebook with what looked like a gun pressed to his head. As the man was diagnosed with bipolar disorder and had a long history of suicide attempts, his doctor made the decision to hospitalise her patient after seeing the picture on his page. The man denied wanting to end his life and voiced his disgust at the intrusion of his privacy and involuntary hospitalisation, which lasted for several days. And when police performed a search on his apartment, they only found a single pellet gun. Professor at Columbia University Paul Appelbaum said cases such as this inadvertently set new legal precedents for mental healthcare. “The standard of care is developed by the clinical community itself,” he told Nautilus. “What most people do, or at least what a substantial number of people do, becomes a standard of care.” This means if examining a patient digital footprint becomes the norm, doctors could become liable for information their client posts online — if the doctor misses a suicide post from a patient that kills themselves, the clinician could potentially be sued for malpractice. “[That future] will depend on us, on the clinical professions and how we choose to use the ability that the internet is giving us,” he said. Mr Appelbaum said building a profile from the digital footprint of patients could also have long-lasting repercussions. “By going online and putting what we find in the chart — whether that’s a summary or a cut-and-paste excerpt or a screenshot — we are creating a new kind of medical record information that didn’t exist previously,” he said. “Unlike some of those sources — which may be hard to find, or ephemeral, and may ultimately disappear — medical records are forever.” The psychiatrist said as third parties routinely access medical records, the data collected could play a role in legal proceedings regarding accidental injury, child custody disputes or criminal cases. This isn’t even to mention criminal profiteering. Source
