Dr Google vs Vets

Part
01
of four
Part
01

Ways to Combat Online Medical Research

Ways to combat online medical research by health care professionals and veterinarians include: blogging answers to most common client questions; directing clients to credible sources; establishing telehealth consultations; empathetic expert advice; social media forums.

BLOGGING ANSWERS TO MOST COMMON CLIENT QUESTIONS

DIRECTING CLIENTS TO CREDIBLE SOURCES

TELEHEALTH: PHONE AND EMAIL CONSULTATIONS

  • Veterinaries should develop their own telehealth services that involves providing veterinary assistance over online or phone channels. Such assistance can bridge the information gap that Google serves.
  • Veterinaries can engage clients over phone and email consultations to provide pet owners with answers to pertinent questions on the health of their pet.

EMPATHETIC EXPERT ADVICE

SOCIAL MEDIA FORUMS

RESEARCH STRATEGY

In order to identify ways health care professionals and veterinarians have combated online medical research, your research team engaged in intensive research across news sources and corporate websites such as AAHA. Particularly, our focus was on strategies veterinaries used to combat client online medical research. Importantly, we provided examples of the strategies identified in practice.


Part
02
of four
Part
02

Ways to Incorporate Online Medical Research

While there is no publicly available information that reports how/why veterinarians or healthcare providers changed their practices based on medical research, the research team used the available data to pull together general findings related to specific medical professionals and their use of medical research (e.g., ways to incorporate medical research). Below is an outline of the research strategies to better understand why the information requested is publicly unavailable, as well as a deep dive into the findings.

Ways to Incorporate Online Medical Research

1. Dr. Ryan Shelton on the use of online medical research:
  • According to Dr. Shelton, online medical research helps doctors explain information to patients regarding their medical condition.
  • While searching for medical information online, Dr. Shelton firstly focuses on the publication dates so as not to share outdated details. The ideal publication date should be 1 or 2 years prior.
  • Further, Dr. Shelton checks the credibility of the author and confirms whether the information is just an opinion or authored by an expert in the field.
  • He further encourages patients to seek information through their own online medical research.
  • Dr. Shelton’s favorite website for online medical research is UpToDate.com which features physician-written content.

2. Dr. Ranit Mishori on the use of online medical research:
  • According to Dr. Mishori, physicians' use online medical research, since they are strapped for time with office visits, should be kept to as short as 15 minutes.
  • Dr. Mishori believes that online medical research enables her to give patients extra information they can further pursue at home.
  • Also, sharing online medical research with patients enables them to understand complex medical issues and engage in an informed dialogue with health care professionals.
  • She recommends the following sources for online medical research: the Centers for Diseas Control and Prevention, National Institutes of Health, the Mayo Clinic, Family Doctor, and WebMD.

3. Dr. Lina Colucci on the use of online medical research: (Source 5):
  • Initially, Dr. Colucci, (who received her Ph.D. in medical engineering and medical physics through the Harvard-MIT Health Sciences and Technology Program) used to use websites such as WebMD, the Mayo Clinic, MerckManuals, and MedlinePlus.gov. However, she found that most of such websites only provide the same basic information which she found unsatisfying.
  • Later, Dr. Colucci came across other websites such as UpToDate, DynaMed and Current, among others, that doctors used instead of some of the more popular sites that are often delivered via Google results.
  • These evidence-based databases provide doctors with all information for treating just about any patient according to the most up-to-date guidelines.
  • Dr. Colucci’s favorite site is UpToDate which features a “Provider Information” section that provides detailed information to healthcare professionals.

Additional Information on Clinicians' Use of Online Medical Research

  • Internet search engine usage is common among healthcare professionals for finding answers to point-of-care clinical questions.
  • A study of internal medicine residents in the United States estimated that 63% used an internet search engine to identify evidence at least daily.
  • One of the most common sources of online health information is Wikipedia, with over 70% of physicians using it for health care information.
  • 91% of physicians consider the internet to be an indispensable professional resource.
  • Top information sources for physicians include professional journals, general web browsers, colleagues and online free services.
  • Physicians now spend twice as much time using online resources as paper resources to make clinical decisions.

Research Strategy

The research started by directly searching for any case studies or stories on veterinarians that have incorporated online medical research (Google) into their practice. However, after an exhaustive search through case studies, white papers, industry publications and press releases by credible veterinarian organizations and associations (e.g., Veterinary Information Network, American Veterinary Medical Association and Journal of Veterinary Science & Technology, among others), we were not able to find any relevant case studies around veterinarians that have incorporated online medical research into their practice. Thereby, we extended our research to healthcare professionals, in general. Further, the team pivoted to search for any industry publications focused on the ways health care professionals have incorporated online medical research into their practice. We came across numerous reports and publications by EBSCO and WeGoHealth that provided useful information including various statistics and qualitative information. The team came across various interviews published by Dr. Shelton, and Dr. Mishori. These interviews provided additional information on how these healthcare professionals have incorporated online medical research into their practices. Additionally, we came across another blog post published by Dr. Colucci, which provided information on how online medical research enables healthcare professionals to treat patients. However, again, this did not provide any useful information on detailed overviews of how the professionals have changed their practice and why they decided to follow that path.

The research team also searched through various healthcare organizations such as the American Medical Association (AMA), American Academy of Family Physicians, American Board of Emergency Medicine and the American Board of Family Medicine, among others. The idea here was to find techniques or best practices recommended by such organizations for healthcare professionals to incorporate online medical research into their practice. We came across a report published by the AMA that only provided various guidelines and ethics in conducting online medical research. However, none of the above-mentioned sources provided any exceptionally detailed overviews of how the professionals have changed their practice and why they have decided to follow that path. Thereby, after exhausting the above-mentioned strategies, we concluded that no case studies with detailed overviews of how the professionals have changed their practice and why they have decided to follow that path are available in the public domain. One of the probable reasons for the unavailability of such information could be that most healthcare associations have only published qualitative and quantitative information on healthcare professionals incorporating online medical research, in general. It could also be possible that individual healthcare professionals have not published detailed overviews of how they have changed their practice and why they have decided to follow that path because they primarily service patients and their time may be scarce for providing analysis of their information strategies.
Part
03
of four
Part
03

Impact of Online Medical Research

Self-diagnosing and online medical research has impacted veterinary practices negatively and positively. It has negatively impacted the economy of the doctors and the industry, caused a delayed diagnosis of an illness or condition, driven pet owners to give an incorrect treatment to their pets, interfered in the veterinarian-patient-client relationship, and a reduced the value associated with the veterinarian's opinion. On the other hand, it has positively impacted them by forcing doctors to create new communication channels with their clients and use technology to create more reliable self-diagnosing tools.

SELF-DIAGNOSING AND ITS IMPACT ON VETERINARY

OVERVIEW
  • Pet websites have evolved in recent years, providing some reliable sources to find pet-health tips, nutrition tips, preventive wellness, exercises, and at-home care for pets, like AVMA and AAHA.
  • However, not every site is reliable, and with the easiness of access to veterinary sites, a lot of pet owners choose to do online medical research and to self-diagnose their pet's before taking them to the doctor.
  • What most pet owners don't realize is that doing so is a gamble on their pet's health.
  • Veterinarians use external and internal examination to determine a pet's condition and identify illnesses, while pet owners rely only on external symptoms due to the lack of experience.
  • Self-diagnosing and doing online medical research is commonly known in the medical field as relying on "Dr. Google."
  • One of the reasons people self-diagnose their pets is to save the expense and time of visiting a doctor.

IMPACT ON PETS AND CUSTOMERS:
  • More than 75% of pet owners do online medical research to answer doubts about their pet's health instead of making an appointment with a veterinary.
  • According to the results of a medical survey in the US, 35% of pet owners confirmed that the first thing they do when their pet is sick or ill is researching online.
  • 15% of pet owners say that, because of the information found online, they don't rely on their veterinary as much as they should.
  • According to the Veterinary Hospital Managers Association, 40% of pet owners have created a mental diagnosis of their pet's health before they visit a clinic.
  • In some cases, they have already administered their pets with some medication or a "natural" treatment" they found online by the time they reach a veterinary, worsening their condition and in some cases intoxicating the animal.
  • Self-diagnosing can potentially delay the proper treatment and lead to further health issues causing harm and distress for the pet.
  • Some other times, they follow their self-made diagnosis treatment and, if they notice it didn't work because their pet is suffering, they reach a doctor for the right diagnosis. They come with elevated and often unreal expectations of the situation, and in some cases arrive too late to treat the animal.
  • Self-diagnosis through online medical research is changing how the clients treat and diagnose their pets, and interfering with the veterinarian-patient relationship that guarantees a better patient care.

IMPACT ON DOCTORS AND HEALTHCARE PROFESSIONALS:
  • Trusting in their self-diagnosis makes many customers second-guess a trained pet health professional's treatment plan and doubt their expertise.
  • A study was conducted in 2017 by Frontiers in Veterinary Science about the relation between the client's internet use and the veterinarian-client relation in the UK and the US, where they identified that the results and statistics between both countries were very similar.
  • Based on this study, 82% of the veterinarians have had a patient who has challenged their diagnosis, professional opinion, or recommendation because of the information they found during their medical research.
  • "Dr. Google" gives customers false security that they understand and know how to interpret correctly the medical information they found online, even better than a professional.
  • This false security reduces the value that customers give to a medical appointment, regarding the cost of the visit and the doctor's opinion.

IMPACT ON THE VETERINARY MEDICAL FIELD AND INDUSTRY:
  • Self-diagnostic is also impacting the perception of veterinary medical care and the field's profitability.
  • This situation impacts veterinarians economically, forcing them to search for new ways to compete with the resources online.
  • It also makes them unable to develop a proper veterinarian-client-patient relationship or give the advice to treat their customers' pets effectively.
  • As veterinarians have accepted that they can't change this behavior, they are modifying the way they connect with their clients to become more approachable and ensure their patients receive the proper diagnosis, creating websites, blogs, and ways to address their questions online.
  • A study by Pew Internet & American Life Project determined that 35% of US adults research medical sources to figure out a medical condition they or another person has before visiting a doctor.
  • The same study indicated that 72% of the people who use the internet have searched for health information in the past year.
  • 73.3% of veterinarians say they have changed their approach and give time to answer the questions their client have from their online searches.
  • 22.2% of veterinarians stated that self-diagnosis has negatively impacted their relationship with their patients.
  • Veterinarians are creating websites to help their clients and recommending reliable sites they can read when they have doubts.

IMPACT ON THE HEALTHCARE INDUSTRY:
  • The healthcare profession is becoming consumer-driven and changing what customers expect from their doctors.
  • 83% of patients in the US said that they felt more comfortable after their doctor agreed to hear and discuss the doubts and concerns they had from their medical research.
  • Also, it is changing the way healthcare institutions and professionals communicate with their patients, forcing them to create websites and communication channels with their patients to ensure they have access to accurate information, instead of data that could be potentially harmful.
  • As self-diagnostic and online medial research is becoming a common practice from patients, the healthcare industry is looking for new ways to use the technology to provide self-diagnosing tools that give correct diagnoses.
  • Self-diagnosing tools that are approved by professionals can benefit the patient and assist the doctor.
Part
04
of four
Part
04

Viable Alternative to Googling Medical Issues

There are many viable alternatives to Googling medical issues. These alternatives include apps, emergency lines, Ask a Vet websites, online consultations, YouTube channels and health related sites.

Apps

  • There are several apps aimed at pet owners that, among other features, provide health and medical-related insights and tips.
  • PetCoach is an app that connects veterinarians and other professionals to pet owners, allowing them to ask these professionals questions regarding their pet’s health for free. Besides asking a veterinarian a question, users also can access vet-authored articles and review previously asked questions.
  • ExpertoAnimal is another app for pet owners that works as a social network, where people share information about pet’s health and medical insights, among other issues. The app also provides information written by professionals.

Emergency Lines

  • Pets Best, a pet health insurer, offers 24/7 Pet Helpline with their policy, a service that provides pet owners with access to veterinarians 24/7 by phone, live chat and email.
  • The American Society for the Prevention of Cruelty to Animals (ASPCA) offers an app that connects users to Animal Poison Control Center and provides information about household hazards from expert toxicologists.
  • ASPCA also has an emergency line for animal poison-related emergencies, available 24 hours a day.

Ask-A-Vet Websites

  • Vet Live lets customers ask veterinarians questions for $59.95, get a nutritional consultation for $59.95, or get a second opinion for $79.95.
  • Ask a Veterinarian online also allows users to get real live answers from veterinarians. The user first goes through a screening process, where they are asked about the issue, the animal type and other information relating to the animal’s health, they are then directed the Just Answer Veterinarians page for payment information.
  • Users can post questions for veterinarians at Vet Babble, and are able to read previously answered questions and articles.

Online Consultation

  • Besides their in-home vet care for those in the New York City or SF Bay Area, Fuzzy offers live consultations about health, lifestyle and activities.
  • VetChat provides both online chat and video consultations with Australian veterinarians.
  • Best Friends Vet Access connects users to certified vets to do preliminary diagnosis, the app offers several options regarding prices, from 1-day access for $3.99 to one-year access for $107.40.

YouTube

  • YouTube could also be a viable alternative to Google, with some channels gathering relevant followings, such as Dr. Andrew Jones, with over 240,000 subscribers.
  • Dr. Jones is an advocate for natural pet health and former veterinarian, his videos are focused on natural solutions for medical or wellness issues pets may have. He talks about several conditions, ranging from fleas to cancer and heart failure.
  • Bondi Vet claims to provide vet advice for different health issues related to pets and the channel, that counts with over 40,000 subscribers, has a variety of videos, from cute animal collections to how to identify if the pet has skin abscess.
  • Created by Dr. Karen Becker, Mercola Healthy Pets has over 89,000 subscribers and focuses mainly on health and medical conditions, such as ear hematomas, lick granuloma, and other conditions.

Websites

  • The Pet Health Center from WebMD offers a great variety of articles, news, symptoms checkers and other features relating to pet’s health, wellness and medical conditions.
  • Healthcare for Pets has articles, videos, Q&As from topics ranging from behavior to vaccination and medical conditions.
  • Vets4Pets has a tool that allows owners to check their pet’s symptoms to see how serious the condition may be, what to do next, first aid advice, what the problem could be, and travel advice.

Sources
Sources

From Part 02
Quotes
  • "Clinicians have a lot of questions, too. Internet search engine usage is common among healthcare professionals for finding answers to point-of-care clinical questions. However, there are issues with using search engines and internet sites—search flaws, unfavorable characteristics of search results and inconsistent site content quality, being the most prevalent. "
  • "For clinicians to provide the most appropriate care, current evidence-based information, obtained via credible resources, must be easily accessed, assessed and applied."
  • "Another study of US internal medicine residents estimated that 63% used an internet search engine to identify evidence at least daily (Duran-Nelson et al., 2013)."
  • "Alternatively, pre-appraised decision support resources save precious time since the information’s already been assessed for credibility, allowing clinicians to apply trustworthy information in caring for patients. "
  • "Information that’s credible, current and of highest quality is essential for providing timely, effective and efficient evidence-based patient care."
Quotes
  • "Many adults, physicians, and medical students search the internet for health information. Open access has many benefits, but the variable quality of internet health information—ranging from evidence based to false—raises ethical concerns."
  • "Health care professionals, including medical students, have both ethical responsibilities to help patients avoid false or misleading health information and practical opportunities to improve the quality of internet health information. "
  • "All users of such information—professionals and patients alike—should develop critical appraisal skills and apply them to internet health information to distinguish the good from the junk."
  • "Clinicians—especially those using the internet for informal professional education7—have an ethical obligation to use their critical appraisal skills to help patients avoid false or misleading health information. "
  • "One of the most common sources of online health information is Wikipedia, with over 70% of physicians using it for health care information,8 as well as over 90% of medical students."
Quotes
  • "Ninety-one percent of physicians consider the internet to be an indispensable professional resource, relying heavily on it for immediately accessible guidance."
  • "Additionally, healthcare professionals have found their own reasons for seeking out health-related information online and via social media."
  • "Following what their colleagues are discussing and sharing is the most popular social media activity for 60% of physicians. Social media sites specifically for healthcare professionals, like Doximity, are cropping up. "
Quotes
  • "Dr. Shelton’s personal favorite website is uptodate.com. It’s easy to use, features physician-written content and has been shown to improve outcomes in patient care."
Quotes
  • "Before my clinical rotations I, too, used to Google symptoms. The top hits would be WebMD.com, MayoClinic.org, MerckManuals.com, or MedlinePlus.gov, which would all regurgitate the same basic information that I found unsatisfying. "
  • "These websites told me exactly what I wanted to know about any condition or symptom accompanied with descriptive photos, reliable references, and trustworthy guidelines for exactly how to treat the condition."
  • "Enter the online world of medical references that your doctor uses instead of Google: UpToDate, DynaMed, Current, and many more. These are medically sound, evidence-based databases that tell doctors most things they need to know to be able to treat just about any patient according to the most up to date guidelines. "
  • "My favorite site is UpToDate, which was started by a nephrologist at Harvard Medical School in 1986 as a scrappy startup operating out of his basement"
  • "Over the past 20 years, UpToDate now has information on just about any medical condition and has grown to over 1.1 million subscribers in over 180 countries around the world"
  • "For every condition, UpToDate has a “Patient Information” section, which contains more basic information put in layman terms, as well as a “Provider Information” section, which goes into more detail and jargon. "
Quotes
  • "And yet she believes the Internet has a strong positive role to play in the doctor/patient relationship. With so many clinicians strapped for time, and office visits kept to as short as 15 minutes, physicians can use reliable sites to give patients extra information they can peruse at home. "
  • "It can help them better understand complex medical issues, and enable them to engage in an informed dialogue with health care professionals."
  • "Also, she is fond of using the Internet to link patients with online listserves for people with similar health issues."
  • "Her favorite websites for patients tend to be those heavily backed by the scientific community, covering a wide range of medical conditions and questions."
  • "At the top of her list: CDC.gov and NIH.gov. Mishori also recommends, as good general references, mayoclinic.com, familydoctor.org, and WEBMD.com."
From Part 04