The Internet Is Making Us Lose Trust In Our Doctors

How well do you trust your doctor?

Is seems that, at least for parents, a level of trust might be impacted by exposure to on-line medical information.  A study presented at the 2017 Pediatric Academic Societies suggests that doctor / patient trust and the drive to a second opinion–in a digital age–might be more fragile than we thought.  In this study, 1,374 parent participants were presented with a vignette of a child who ‘has had a rash and worsening fever for 3 days.’ The participants were divided into three groups and the first two were presented with information related to the symptoms as computer screen shots.

  • Group one was presented with screen shots of clinical information on scarlet fever.
  • Group two was presented with screen shots of clinical information on Kawasaki Disease (a condition that causes inflammation in the walls of blood vessels).
  • Group three received no internet screenshots.

After which, all three groups were informed that that physician had diagnosed the child with scarlet fever and then asked to rate their level of trust in the diagnosis from 1 (Not at all) to 7 (Completely). Parents were also asked to rate their likelihood of seeking a second opinion regarding the diagnosis, from 1 (Extremely Unlikely) to 7 (Extremely Likely).

Physician and Patient Trust

With permission. Ruth Malanaik

Source: Ruth Malaniak MD

The results suggest that prior exposure to information can ‘prime’ a parent to have a unique bias. This bias can impact the trust that has been established with a physician and even change the care pathway.  And this result was supported statistically–the three cohorts significantly differed in reported trust in the doctors’ diagnosis (p < .001) and reported likelihood of seeking a second opinion.  The authors concluded:

After reading online search results, parents were more inclined to trust their doctor’s Dx (diagnosis) when online information supported their doctor Dx and less inclined when information contradicted the doctor. Parents were also more likely to seek a SO (second opinion) if internet results contradicted the doctor Dx. Although it is imperative that parents participate in the medical decision-making process, conflicting online information could in some cases delay necessary medical treatment. Physicians must be aware of the influence the internet may have on parents and ensure adequate parental education to address any possible concerns.

While this ‘artificial’ scenario may not accurately reflect everyday life or clinical practice, the results seem to indicate that exposure to clinical information on-line may ‘prime’ parents to particular point of view and predisposition to action. I’m reminded of work done by John Bargh, a social psychologist who studied how people, given prior exposure to information, can have that point of view reflected in their subsequent opinion or actions. This concept was popularized by Malcolm Gladwell in his best selling book Blink.

In this study, we can see how information obtained on-line can directly impact the caregivers’ perceptions of decisions and recommendations of a physician.  Dr. Ruth Milaniak MD, the lead investigator of this study, supports this observation and offers some important advice.

Every time I speak with my patients, I always have in the back of my mind what on-line influence may have already impacted our dialogue.  The internet is emerging as ‘the elephant exam room’ and we as clinicians need to understand this and communicate with patients and caregivers accordingly.

In an era where doctor / patient communication can be time-limited, the role of on-line support may play and increasing role. And as more and more, patients look to Dr. Google as a primary source of medical information, the key question that emerges is if that ‘digital information’ helps or hurts clinical care.

Follow me @JohnNosta for a more informed and healthy future.


Is HTC making the next Pixel phones for Google?

An HTC blog has recently unearthed certain system files that indicate a possible relation between the HTC U11 and the upcoming Pixels.
 The Google phones might drop the delicate rear glass panels from the U11’s body and adapt a metallic body along with a rear fingerprint sensor.

The Google Pixel is the Holy Grail of all Android smartphones. It is the guideline around which other manufacturers build their iterations of Android-based smartphones. The astonishing fact about the Pixel is that it has been designed and made by HTC, one of the pioneers in the world of Google’s open source operating system. That reassures a Pixel customer that the phones would stand the test of time and provide the best hardware experience, even though with conservative designs. And, it seems that HTC is going to do that with the next generation of Pixel smartphones as well.The Google phones might drop the delicate rear glass panels from the U11's body and adapt a metallic body along with a rear fingerprint sensor.

A Japanese blog, called HTCSoku, has found a reference to the next generation Pixel phones while playing around with the HTC U11’s file system. The HTC U11’s system files have references to ‘S2’ and ‘M2’. The current generation of Google Pixel and Pixel XL phones had the codenames ‘S1’ and ‘M1’ respectively during their development process, which was loosely based on the HTC A9 and the HTC 10. Therefore, the next generation of the Pixel smartphones should be called the ‘S2’ and ‘M2’. The blog also found links of the ‘S2’ and ‘M2’ files with the Snapdragon 835 chip set.

This renders speculations that Google’s next generation of Pixel smartphones will be based on the existing HTC U11. The Google phones might drop the delicate rear glass panels and adapt a metallic body along with a rear fingerprint sensor. They could be running on the SD835 chipset with 4GB of RAM and 64/128GB of storage. Since there’s no dual camera sensor on the U11, the 2017 Google flagships could also be sporting single lens rear camera. However, the Edge Sense feature from the U11 may not find a place on Google’s smartphones as it is an exclusive feature to the 2017 HTC flagship. And, they will have a solid build quality as well.

The Google Pixel 2 smartphone range could be unveiled later in the year. Stay tuned for further updates on the next generation Google Pixel smartphones.