How To Help Patients Find Information They Can Trust
“It ain’t what you don’t know that gets you into trouble,” Mark Twain supposedly said. “It’s what you know for sure that just ain’t so.”
Medical and dental professionals today face a patient population better armed with health care information than ever before—and that’s a good thing. The more people know, the more they can make healthy decisions about their lives and be effective partners when it’s time for treatment.
Emily Van Heukelom, DDS
But, as with many good things, there’s a downside: patients who come in with health information they’ve confidently culled from the Internet, TV, radio, magazines, or newspapers—or even from social media or neighbors—that has misled them. It could be reports that they’ve misinterpreted—or that are perfectly valid but don’t apply to them—or in some instances that are flat wrong.
The Internet may be the biggest offender, because online, the boundaries are less clear than in older media between people trying to tell you something and people trying to sell you something. “Much of what’s on the Internet boils down to advertising,” warns Emily Van Heukelom, D.D.S., of the Center for Oral Surgery and Dental Implants (COSDI).
Dr. Van Heukelom says the Internet and other media can be great sources for questions patients can ask their clinicians. But a patient’s seizing upon them for answers can be a problem.
When patients get it wrong
“I’ve had patients after wisdom-tooth surgery who have diagnosed themselves,” says the oral surgeon. “They’re sure they have an infection or a dry socket. And I’ll say, ‘Actually, I think this is more straightforward. There’s a suture there, and some food is trapped underneath it. Let’s just flush that out and let you sit for ten or fifteen minutes. I think it’s going to feel much better.’”
When Dr. Van Heukelom turns out to be right on such occasions, she says, little harm has usually been done beyond the patient’s “excessive worry.” “But in occasional cases,” she says, “the incorrect information has undermined the patient’s relationship of trust with the clinician.”
Sensitivity to the patient’s point of view is a bedrock principle for COSDI, and that doesn’t stop when it’s time to gently correct misinformation. But Dr. Van Heukelom does have three points she stresses with patients to help them make sure the health information they find online isn’t biased or problematic:
Find Out a Website’s Purpose
Many sites offer information about dental or medical conditions as a prelude to a pitch for a product or service that may or may not be right for your patient. Often, the information is couched to make the product or service seem the perfect answer to the patient’s problem—perhaps a new breakthrough just announced. “But if it sounds too good to be true,” says Dr. Van Heukelom, “it probably is.”
Don’t Trust Social Media
Today’s proliferation of instant digital get-togethers and comparisons can be fun and can be useful for sharing many things. But patients just plain shouldn’t use social media—ever—for diagnosing and treating medical or dental conditions, says Dr. Van Heukelom, just as they shouldn’t take pills handed to them by a neighbor over the back fence.
Check a Site’s Domain Name
As a government website explains, four suffixes that are part of web addresses can tell you something about the evenhandedness of a site’s approach.
Common Domain Suffixes
.gov: a U.S. government agency, usually reliable and kept up-to-date with the latest research.
.edu: an educational institution. Such a site may extol the virtues of its university or research center and be in that sense biased—it may boast, for example, of that institution’s own research accomplishments—but its health care content can usually be trusted because intellectual credibility is its stock in trade.
.org: a nonprofit organization, such as a medical society, an advocacy group, or a treatment facility—the Michigan Dental Association, the American Heart Association, and the Mayo Clinic are examples. These sites may advocate for a professional community or a disease constituency (a specialty society’s site, for instance, may not provide equal coverage of another specialty that offers similar services), but their content on medical or dental issues is usually unbiased and based on peer-reviewed science.
.com: a commercial enterprise, which may sometimes have splendid information, but which is driven by a business mission, not an informational one. Read with a cautious eye.
Another hint is to beware of online search algorithms that send users to paid content, which can be slanted. The label “sponsored,” often at the top of a list of search results, indicates such paid entries. The information they contain may be perfectly fine, but you should know—and consider—that someone has paid to have you directed to it.
What studies show—and What they don’t
Digging a little deeper, some patients will come into the office having read about new clinical research and drawn conclusions from it. Giving these individuals a bit of guidance about how to assess what they’ve read can be helpful. Take sampling error, for instance. “If you flip a penny a hundred times, then repeat that over and over,” says Dr. Van Heukelom, “once in a while, out of your first twenty flips, fifteen will be tails. That doesn’t change the fact that it’s a 50–50 probability. You’ve just had a sample error.”
Similarly, says the doctor, in some rare or newly discovered conditions, the literature may consist only of case reports, which a patient may overinterpret. But case reports can differ widely, just as those pennies can. “A retrospective study is stronger than case reports,” she explains, “and a prospective study is better still, because it’s designed to eliminate bias. Best of all is a randomized clinical trial, which has gone through an institutional review board.”
Even the soundest studies can be complex, and sometimes the portion of a study’s findings that is genuinely new knowledge isn’t fully clear. That’s especially true if one is learning about those findings from headline writers or the writers of TV news or Internet lead-ins, who have simplified them with an emphasis on novelty to attract readers, viewers or clicks.
The consumer mindset
“Medicine is growing and changing, and so is dentistry,” says Dr. Van Heukelom. “But hopefully we are growing and changing for the benefit of our patients, by and large, and not just the shareholders of our companies.”
Today’s consumer has a new mentality that demands answers—and again, that can be very constructive. A patient with informed questions is ready to be knowledgeable and adherent to treatment and any necessary lifestyle adjustments. But patients should direct their skepticism wisely—they should, for example, be wary of professionals who make exact, low-ball promises about cost or duration in matters that inherently resist such precise prediction. “If you’re going to nickel-and-dime things, you may not get the best result,” says Dr. Van Heukelom.
Even in the age of the Internet, she argues, what counts most is the relationship of trust a patient builds with his or her providers. They, after all, have gone to dental or medical school, while the patient usually has not—it’s simple prudence to tap their expertise.
Dr. Van Heukelom tells patients,
“You need to find a place where the practitioners meet your level of needs, offer you a path forward that makes sense, and don’t overtly try to push you towards one decision or another. There are many ways to replace a missing tooth, for example. Let’s talk about two or three of those and why I think one is the best choice for you. If you feel good about that, awesome—I’ll give you a plan. If you prefer to think more about it, fine—I’m not going to twist your arm. I’m just here to give you the information. And then, when you’re ready, if you’re ready, we’ll take good care of you.”
https://medlineplus.gov/evaluatinghealthinformation.html , accessed online May 7, 2024.
Where patients can learn more:
Valuable advice on assessing medical and dental content on the Internet is available at https://medlinelus.gov/evaluatinghealthinformation.html, a government site from the National Library of Medicine. Useful information on oral surgery topics is also available at the Center for Oral Surgery + Dental Implants (COSDI) site: https://www.grandrapidsoralsurgery.com.
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