‘A heartbeat moment’: qualitative study of GP views of patients bringing health information from the internet to a consultation
Open accessAbstract
BACKGROUND: Government policy is to encourage self-help among patients. The internet is increasingly being used for health information. The literature on the role of the internet in the doctor-patient consultation remains sparse. AIM: To determine the perceived responses of GPs to internet-informed patients in consultations and the strategies GPs use for dealing with information from the internet being brought into consultations. DESIGN OF STUDY: A qualitative study design was used, with semi-structured interviews. SETTING: GPs based in North Central London. METHOD: Analysis was conducted by a multidisciplinary team of researchers. Participants were 11 GPs: five partners, three locums, and three salaried doctors; seven were white, three were Asian, and one was of Chinese origin. The median year of General Medical Council (GMC) registration was 1989. There were six women and five men; five participants worked in training practices. RESULTS: GPs experienced considerable anxiety in response to patients bringing information from the internet to a consultation but were able to resolve this anxiety. The study participants learned to distance themselves from their emotional response, and used cognitive and behavioural techniques to assist them in responding appropriately to patients. These techniques included buying time in a consultation, learning from previous consultations, and using the internet as an ally, by directing patients to particular websites. The importance for doctors of feeling valued by patients was apparent, as was the effect of the prior doctor-patient relationship. CONCLUSION: GPs interviewed used sophisticated mechanisms for dealing with their emotions. GPs struggling with internet-informed patients can use the mechanisms described to alleviate the difficulties.
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Many HCPs perceive online health information to be useful and beneficial because it allows patients and the public access to a wealth of knowledge on health-related issues.
“Many HCP’s perceive online health information to be useful and beneficial in terms of the fact that it allows patients and the public access to a wealth of knowledge on health-related issues [28, 43, 47].”
Several HCPs believed that the internet poses risks as patients may misinterpret information and this can cause unnecessary medical visits.
“Several HCP’s also believed that the internet poses risks as patients may misinterpret information and this can also cause unnecessary medical visits [28, 48].”
There is a known fear among HCPs of losing control of the consultation with internet-informed patients and of being perceived as incompetent.
“There is also a known fear of losing control of the consultation with internet-informed patients and the feeling of being perceived as incompetent [28].”
Some physicians interpreted online health information seeking as suggesting a lack of trust in their medical expertise.
“Some physicians interpreted online health information seeking as suggesting a lack of trust in their medical expertise [28, 47].”
Patients/public found adopted reactions from HCPs such as open body language and asking open questions, making the environment more comfortable and allowing them to feel more listened to, encouraging.
“Patients/public found adopted reactions from HCP’s such as open body language and asking open questions, making the environment more comfortable and allowing them to feel more listened to, encouraging [28].”
Some HCPs deliberately showed respect when presented with online health information as a way of making sure patients felt listened to and respected, in the hope of encouraging patients to continue self-care.
“Some HCP’s deliberately showed respect when presented with online health information as a way of making sure patients felt listened to and respected, in the hope of encouraging patients to continue self-care [28].”
Adopting this approach allows more trust to develop between the patients and HCPs.
“Adopting this approach allows more trust to develop between the patients and HCP’s [28].”
When HCPs create an atmosphere that is open, this can encourage patients to discuss the information they have discovered; additionally the patient's perception of invading the role of the HCP or their embarrassment may be reduced, which, overall, can enhance the relationship between the patient and HCP.
“When HCP’s create an atmosphere that is open, this can encourage patients to discuss the information they have discovered; additionally the patient’s perception of invading the role of the HCP or their embarrassment may be reduced, which, overall, can enhance the relationship between the patient and HCP [28, 38].”
Some HCPs thought online health information could cause anxiety among patients - especially when the information was misinterpreted, and this could lead to unnecessary medical visits.
“Some also thought it could cause anxiety among patients – especially when the information was misinterpreted, and this could lead to unnecessary medical visits [28, 48].”
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- Authors
- Ahluwalia, S., Murray, E., Stevenson, F., Kerr, C., & Burns, J.
- Affiliations
- London South Bank University (GB)
- Venue
- British Journal of General Practice
- Published
- 2010-02-01
- Volume
- 60
- Issue
- 571
- Pages
- 88-94
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC2814261
- OpenAlex
- W1986943941
- Cited by
- 108
- References
- 26
- Citations by year
- 2025: 3 · 2024: 11 · 2023: 9 · 2022: 4 · 2021: 7 · 2020: 13 · 2019: 13 · 2018: 9 · 2017: 4 · 2016: 8 · 2015: 5 · 2014: 5 · 2013: 7 · 2012: 8
- FWCI
- 9.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- online health information, doctor-patient consultation, general practitioners, self-help, physician-patient relationship
- MeSH terms
- Attitude of Health Personnel, Female, Humans, London, Male, Patient Participation, Physician-Patient Relations, Physicians, Family, Professional Practice, Internet, Consumer Health Information
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