The internet has made medical education and resources readily available for patients, but it can also be rife with misinformation. For physicians, this can mean patients might come to them with their knowledge and/or preconceptions about their care.
Nine spine surgeons discuss how they navigate conversations in the digital age.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all spine surgeon and specialist responses.
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Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, Nov. 18.
Editor’s note: Responses were lightly edited for clarity.
Question: How do you educate patients who come in with strong opinions shaped by “Dr. Google” or social media?
Hansen Bow, MD. PhD. UCI Health (Orange, Calif.): Over the past three decades, the internet has become one of the most valuable sources of knowledge for both patients and clinicians. In many cases, it has decreased the information asymmetry between patients and their providers. However, in some situations the information provided may lead patients down the wrong path. I see my role as providing solid medical information so that the patient can make the best decision for him or herself.
I believe it is important to respectfully ask the patient which online resources contributed to their opinion. Sometimes the patient’s signs, symptoms, or diagnostic studies do not match with the situation described online. For these patients, the treatment would not apply to the patient’s condition. Viral posts on social media may highlight unusual treatments or outcomes. As a medical professional, I may be able to provide context to these posts and describe treatments and outcomes that are more mainstream and typical. Lastly, I may be able to curate search engine results to highlight treatments that are supported by the most rigorous clinical trials. In these ways, the patient and I can work together to formulate the best treatment plan.
Jordan Iordanou, MD, PhD. McHugh Neurosurgery (West Islip, N.Y.): I address “Dr. Google” opinions by validating patients’ research efforts while gently correcting misinformation with evidence-based explanations. Using visuals and simplified terms, I clarify their condition and treatment options. I find that this approach builds trust and ensures informed decision-making, aligning expectations with clinical realities.
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): I don’t mind social media and Dr. Google as part of the team, as long as I can be the attending!
I like to tell my patients “You’ve done your homework, now let’s make sure it’s the right textbook.” Social media and Google search results have given patients access to more information than ever, and also more misinformation than ever. I have the patients explain to me what they have read, and we talk through their readings and sift through what is correct, what may be exaggerated, and what is wrong/missing; since these algorithms can’t often provide context and nuance and many social media posts gloss over.
Ultimately, these sources are here to stay, so we need to turn them into an opportunity. It forces us as surgeons to communicate better, simplify complex ideas, and further develop that relationship (that social media hopefully can’t do).
Jeremy Smith, MD. Hoag Orthopedic Institute: When patients arrive with strong opinions influenced by online sources, I start by acknowledging their effort to learn about their health. I then clarify that while the internet can be helpful, it doesn’t always provide context, and what may be true in one situation may not apply to their specific medical condition. I encourage us to look at the evidence together, explain the rationale behind diagnostic or treatment decisions, and highlight what we know from reputable clinical research or guidelines. The goal is not to dismiss their concerns, but to partner with them in sorting reliable information from misleading content, ensuring they feel heard while still receiving safe, evidence-based care.
Noam Stadlan, MD. Endeavor Health Neurosciences Institute (Skokie and Highland Park, Ill.): Patients need to be well-educated on their problems to be able to make the best possible decision regarding their care, so I welcome patients who have educated themselves. Some patients seek information to feel some semblance of control over a situation that frequently feels out of their control. It is important to acknowledge and address any feelings of lack of control and help the patients maintain their emotional and psychological balance while assisting them in making decisions based on accurate information; therefore, it is essential to gently but firmly address any misconceptions or erroneous information they get online. Educating the patient is an essential part of the informed consent process, not just from a legal perspective, but especially from an ethical and moral perspective. Some patients will need to see lists of studies and references, others will be more swayed by expertise and still others by stories from personal experience. The most important points to keep in mind are to maintain a good physician-patient relationship, understand where the patient is coming from and make sure patients have accurate information so they can make the best decision for their care.
Karl Swann, MD. Neurosurgical Associates of San Antonio: “Dr. Google,” TV doctors, infomercials, friends, neighbors, teammates, relatives, co-workers and strangers all play roles offering advice to our patients solicited or otherwise.
The concept is far from new. “Dr. Google” is yet another commonly utilized pathway of potential medical decision making influence. I suspect most physicians have used it. The speed and comprehensive depth of AI will increase self-consultation even further.
The way I have handled the “Dr. Google” phenomenon as it affects surgical recommendations is to acknowledge and understand the importance of all the various influences on the patient and to point out areas of both agreement and disagreement. Ultimately, I advise that they choose a surgeon — not a procedure — and follow the advice given.
There will be some patients who continue to search for a surgeon whose recommendation follows what they have concluded after reading a computer screen. Most patients, however, accept the recommendation to prioritize selection of their surgeon over advice rendered by “Dr. Google” on the Internet.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Research on health information seeking behavior shows that 80% of internet users search for health information online, but the quality varies dramatically. Patients often arrive with predetermined conclusions based on incomplete or inaccurate information. Effective counter-strategies include providing high-quality, evidence-based resources proactively, using visual aids to explain complex conditions, and employing shared decision-making frameworks that acknowledge patients’ concerns while introducing accurate information. The challenge is addressing misinformation without dismissing patients’ efforts to understand their condition. Studies suggest that patients who feel heard are more receptive to corrective information than those who feel dismissed or criticized for their research efforts.
Jacky Yeung, MD. Yale School of Medicine (New Haven, Conn.): It’s a daily reality now — patients often arrive with a diagnosis or treatment plan already in mind, courtesy of Dr. Google or social media. I never dismiss that outright, because it shows they’re engaged and curious about their health. But part of our responsibility as surgeons is to help them separate anecdote from evidence.
I take the time to walk them through what’s accurate, what’s outdated, and what’s simply not supported by science. I often pull up their imaging or studies right in the room; visuals are powerful in helping patients understand what’s really going on. The goal isn’t to correct them, it’s to build trust through education. Once they see the rationale behind our recommendations, most patients become very receptive.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Invariably and agonizingly encountered in all aspects of medicine during interviews and prospective treatment discussions. Initially endured, currently and straightforwardly addressed from the outset similar to ‘I have a friend,’ or ‘I’ve heard that’ type of interjections.
The discussion from our end starts with evincing an opinion and recommendation, borne of decades-long experience of both success and failure. Arming oneself with a Youube short video or someone else’s negative bent on any surgery belongs in their insipid opinion-based category of the marginally relevant. Painstakingly dispatched without confrontation, but referenced with radiological demonstration and substantive direction.
These moments of education are concluded with acknowledged questions and mutual decision. Being informed is so important as a patient. Being an unrecognized expert or internet doyen is threadbare and overused.
