Dr. Google: How online diagnoses are changing the doctor-patient relationship
No automated phone message. No hold music playing ten minutes of Mozart's "Eine kleine Nachtmusik." No stressed-out receptionist on the other end of the line, shouting over the background noise of the practice. No appointment four weeks in the future. No crowded waiting room where other patients are coughing and barking. No doctor's appointment that only lasts a few minutes because the next patients are already waiting for their appointment.
Dr. Google always has time. Every day, 24 hours a day, seven days a week, 365 days a year. He always has a listening ear, answers question after question, and provides his patients with all the information he deems helpful within seconds. Simple, fast, and easy to understand.
Dr. Google, the digital demigod in white.
Gone are the days when people with symptoms would consult medical books or dig out grandma's old home remedies. These days, if you want to know if you're seriously ill, you turn to the internet. A search for "right hip hurts when climbing stairs" reveals that it could be the beginning of hip osteoarthritis – or perhaps it's just overworked muscles and tendons. Headache at the back of your head? Possibly a muscle strain or a cervical spine problem. Poor vision in the dark? Either dry eyes or cataracts.
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That's the problem with Dr. Google: His diagnoses are diverse, but often vague – and sometimes even wrong and misleading. And yet, he remains popular with his patients. A recent analysis by the Bertelsmann Foundation , for which the opinion research company forsa surveyed 2,000 German citizens online, revealed that 87 percent of participants search the internet for information on health topics. The most frequently used source of information is search engines, but AI chatbots are also popular.
In times of digitalization, where analog is being replaced by digital, this development is only logical. However, there are limits: Dr. Google can make diagnoses, but he cannot prescribe medications or issue sick notes, perform blood tests or ultrasounds, carry out surgeries, and he will never engage in social interaction with his patients. Dr. Google will therefore never be able to replace doctors – but he does challenge the doctor-patient relationship.
For centuries, doctors were the first people to turn to for physical and mental ailments. Why is it now an inanimate machine that is taking on this role? A question that medical professionals must certainly ask themselves.
Christiane Eichenberg, who researches online health searches at the Sigmund Freud Private University, sees several reasons for this: "People want to inform themselves," she said last year in an article in "Ärzte Woche" (Doctors' Week) . "Patients question the doctor's expertise or don't trust them. Others, in turn, want more information than they receive from the doctor."
How satisfied are Germans with the healthcare system? The RND Health Compass shows: There is a great need for improvement, especially in rural areas and regarding specialists. And those surveyed raise the question of fairness.
Dr. Google is primarily a stopgap. A substitute doctor who steps in when human doctors don't. This is often because they lack the time: a 2017 study by Cambridge University showed that doctors in Germany spend an average of just 7.6 minutes per patient. Thoroughly examining patients and conducting a comprehensive diagnosis is hardly possible in this timeframe. This makes building trust all the more difficult.
With the help of Dr. Google and his colleagues, such as AI chatbots, people have the opportunity to form their own opinions on health issues. They gain increasing health literacy, learn to understand and question diagnoses and treatment recommendations, and ultimately take responsibility for their own illnesses. Because knowing what is happening in one's own body, how to protect it from disease, or how to support it in case of illness, is not something that patients should leave solely to doctors.
An informed patient is a desirable patient. And yet, from the perspective of medical professionals – this cannot be denied – they can also be a difficult patient. Because where people with different perspectives, experiences, and levels of knowledge meet, complex discussions are inevitable. Meeting each other as equals is the greatest challenge here.
In a 2016 analysis by the Bertelsmann Foundation, more than half of the surveyed general practitioners stated that they found informed patients problematic, at the very least. This was because these patients often came to their practices with unrealistic expectations or were confused by their own attempts to find information. Nearly one in four respondents even advised patients against seeking information on their own.
Of course, online self-diagnosis also has its downsides. For example, symptoms can be downplayed, leading people to avoid seeing a doctor altogether, which can have life-threatening consequences. However, the opposite can also happen: people might "Google themselves sick." Experts call this "cyberchondria," when people become convinced they have a serious, rare disease after intensive internet research.
A 2020 study by the University of Cologne concluded that even five minutes of googling one's symptoms increases one's own discomfort. "Online research about one's own ailments can therefore actually lead to someone feeling sicker than they are, and to a less favorable course of the illness," the research team led by psychologist Alexander Gerlach explained at the time.
It's therefore also important to find a healthy way to use Dr. Google. This means patients should critically question information and check the sources. Does the information come from a reputable medical article with scientific experts, or from the tabloid press? When was the article last updated? It may already be outdated.
Doctors can also use this educational work to their advantage. Dr. Google doesn't have to be a nuisance; it can also be an opportunity. Instead of being suspicious of informed patients, doctors should empower them with further information to gain a better understanding. For example, by providing them with tips on trustworthy digital sources.
In this way, both doctors and patients can benefit from Dr. Google and similar search engines. Thorough research before a doctor's visit can help to better understand the patient and ask the right questions.
Above all, it is crucial that physicians are open to their digital colleagues. Patients must feel comfortable telling their healthcare providers what they have read online about their symptoms and treatment options. Conversely, physicians must develop digital skills to integrate information from the internet into the doctor-patient consultation and transform it into knowledge. Only in this way can the new doctor-patient relationship function in the age of Dr. Google.
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