Should doctors “check out” their patients on social media before seeing them?

By Clive Flashman, Managing Director of Flashfuture Consulting
(First published in association with CSC)

I went to the doctor. He x-rayed my head.
He stared for a moment and here's what he said.
"With all of the junk that you have in your head
it's kind of amazing you got out of bed.
The good news, at least, is you shouldn't feel pain.
From what I can see here you don't have a brain.” By Kenn Nesbitt

When we go to the doctor, we may or may not have a pre-existing relationship with them. Maybe they are a family GP, who has known us since we were a kid and is almost a part of the family. Perhaps they are a doctor we have been referred to but never met before. Both hopefully know something about us, but there’s a difference between 20 years of visits and records and a short referral letter.

If the doctor doesn’t know much about us, should they do some “digging” on the Web and see what they can find out about us? By “Googling” they can find out information about the type of work we do, our address, and therefore your socio-economic group, our lifestyle and interests, even the sorts of topics that make you vocal (in 140 characters or less!).

In 2015, a research paper by professors at the Penn State College of Medicine highlighted the very real issue of doctors “Googling” their patients and questioned whether it was ethical. The paper suggested that guidelines should be put in place for doctors, as there is virtually no guidance available to them at the moment.

The code of conduct that the Penn State professors (including Maria Baker, Professor of Medicine) propose will have to include circumstances in which a doctor is justified in searching the Web for more information about their patients. These could include:

Duty to re-contact/warn patient of possible harm
Evidence of doctor shopping (visiting different doctors until a desired outcome is acquired)
Evasive responses to logical clinical questions
Claims in a patient's personal or family history that seem improbable
Discrepancies between a patient's verbal history and clinical documentation
Levels of urgency/aggressiveness are not justified by clinical assessment
Receipt of discrediting information from other reliable health professionals that calls the patient's story into question
Inconsistent statements by the patient, or between a patient and their family members
Suspicions regarding physical and/or substance abuse
Concerns regarding suicide risk

Personally, I want my doctor to listen to what I have to say with an open mind. Any credible physician with experience has developed ways of ferreting out information quickly from their patients and can make an educated guess about whether they are being told the truth or not.

Medicine is very much a “people business” and the key characteristic of the transactions carried out is trust. If there is an erosion of that trust, then the relationship will fail, and the efficacy of the diagnoses and treatments delivered may well follow that same path.

Of course, I would want my doctor to have the most accurate information about me, so they can make the best decision about my care plan. If I was silly enough to lie to my doctor, then I would deserve the repercussions of that decision. Should the doctor try to counter that by doing their own research on me? I don’t think they should. While my doctor has a duty of care towards me, trawling the Web for my personal information is going well beyond what should reasonably be expected of them. Also, I’d be surprised if many doctors could actually find the time to do this.

I do recognize however, that doctors treat a wide variety of people, some of whom may be less rational or on a pathway to self-destruction. In those circumstances, should they go on a detective hunt, and if so, how far should they go? As the Penn State professors conclude, it’s an increasingly important question in the Internet age.