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5 Tips for Approaching the 'Internet Expert' Patient

Mena Mirhom, MD

Disclosures

October 28, 2021

"Can you diagnose me with this? I saw it on TikTok and I'm sure I have it."

The first time I heard this from a patient, I had to Google what TikTok even was. I came to find out that the usual internet search of random symptoms has now evolved into searching social media for diagnostic criteria.

How are we to react to this new trend?

1. Resist the urge to be dismissive.

"Don't confuse your Google search for my medical degree" is the old quote that you may have heard or even said. It now may be closer to "do not confuse your TikTok views for my thousands of hours of training."

It is natural to be somewhat defensive when a patient approaches a trained healthcare professional with information that they gathered from a potentially less reliable source such as social media. However, we must first recognize that if we respond with hostility or defensiveness, we do not help the alliance that we want to build with the patient. As frustrating as it may be at times, we must learn to coexist with the reality that our patients will be getting information from social media and not our favorite medical journal.

2. Join the patient first.

If a patient is searching the dark corners of the internet for information, tips, and community, there is a reason! We can first take the opportunity to meet the patient where they are and acknowledge that they are struggling with something here. We can even commend them on their attempt to be a well-informed patient. This will open a door of conversation with the patient who can see that we are actually concerned about their pain and are validating their effort rather than just fact-checking their sources.

3. Take a "mis-information" history.

We may have our own impressions or experiences with social media. Our newsfeeds can be radically different as each algorithm attempts to personalize its approach to maximize our time logged on. So another critical step before we assume the patient's experience is to gather data. Who are they following? What are those people's credentials? What makes them feel connected to this person and the information they share? There is a growing trend whereby board-certified physicians and other healthcare workers are getting on social media and providing free, reliable, and evidence-based information in 15 seconds.

4. Guide the patient on how to choose reliable information.

During healthcare training, one of the skills that is learned and acquired is how to evaluate data critically. Developing a critical lens for social media content is probably just as valuable in the age we currently live in. We can help patients with one or two things to look for in particular when evaluating information, such as an individual's credentials, experience, agenda, and/or sponsorship. Is the video or tweet part of paid programming? Content creators are required to indicate that their content is part of an "#ad" or "paid partnership," but this can be subtle and missed by a viewer who is not looking for it.

The patient may not become an expert in spotting misinformation, but this is a good start.

5. Develop a social media referral network.

Rather than telling a patient that the internet is simply unreliable (which it certainly can be) or that social media is full of misinformation (which it certainly is), it may be more productive to "refer" a patient to trusted sources. Finding these sources within your specialty may take some work.

If you are not satisfied with what you find and feel that there is a void in that space, consider becoming that resource! It can be tremendously rewarding to help guide patients with brief, reliable information in the palm of their hands.

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About Dr. Mena Mirhom
Mena Mirhom, MD, is an assistant professor of psychiatry at Columbia University and teaches writing to public psychiatry fellows. He is a board-certified psychiatrist and a consultant for the National Basketball Players Association, treating NBA players and staff.
Connect with him on Twitter @drmirhom, Instagram (@drmirhom), or at Drmirhom.com

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