Orthopedic Surgeons Are Willing to Provide an "internet Prescription" for Their Patients
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Abstract
Background
In the 21st century, internet is a major source of health information for patients and their relatives. Many physicians refer their patients to various sites and some even run their own. However, the quality and the integrity of this information are variable and in many cases it has clear economic interests. Sometimes it does not take into account different treatment options, creating a conflict between the physician and the patient. Professional medical organizations try to deliver more reliable and non-biased sites, but these are few among thousands of others. Thus we hypothesized that physicians, and especially surgeons, will mistrust this channel of patient education. This study was conducted to examine the attitude of orthopedic surgeons toward internet-educated patient.
Methods
This is a cross-sectional survey of nationally representative sample of orthopedic surgeons. We prepared a questionnaire about surgeons' attitude to their patients’ internet use which contained 12 closed questions, asking about: the percentage of patients who search the internet; referral of patients to different education sites; data quality; influence of internet-educated patient on physician's authority, doctor-patient relationship, patient's control perception and compliance, unnecessary tests and interventions and final health outcome. A questionnaire was administered to orthopedic surgeons, both board-certified and residents, during an annual National Orthopedic Association meeting. The questionnaire was offered to all the surgeons attending the meeting and they were aggressively urged to fill it. 201 surgeons filled the questionnaire. Their mean age was 46±11 years. 62 were residents (mean age 35±4 years) and 139 were attending surgeons (mean age 51±9 years). The later were 12±10 years after the board exams.
Results
83% of surgeons referred their patients to different internet sites, however 27% did it only rarely. 62% of surgeons felt that the quality of information is fair, 27% felt that the quality is good or excellent. Most of surgeons believed that internet does not jeopardize their authority (71%), doctor-patient relationship (77%), and patient's control perception (91%) and compliance (84%). However, 74% of surgeons were concerned that internet-educated patients are exposed to unnecessary tests and interventions. When examined by professional age (residents, young specialists, older specialists), an interesting trend is seen. Younger surgeons (residents and young specialists) rarely refer their patients to internet as opposed to older specialists (p<0.5). However, after 20 years experience, this trend stops. A similar trend is seen when asked about the data quality (p=0.08). 90% of surgeons wanted the National Orthopedic Association to develop a site that can serve as an "internet prescription" for patients' referral. 45% agreed to participate in this project, however only small minority supplied their connecting details.
Conclusions
In our study we found a positive attitude among orthopedic surgeons towards internet-educated patients. However, some overdiagnosis and overtreatment can happen. Younger and older surgeons are less internet-friendly, probably because of lower professional confidence in the first group and lower internet literacy in the second. National Orthopedic Associations can play an important role in preparing good-quality sites to be an "internet prescriptions" in different fields of orthopedic surgery.
In the 21st century, internet is a major source of health information for patients and their relatives. Many physicians refer their patients to various sites and some even run their own. However, the quality and the integrity of this information are variable and in many cases it has clear economic interests. Sometimes it does not take into account different treatment options, creating a conflict between the physician and the patient. Professional medical organizations try to deliver more reliable and non-biased sites, but these are few among thousands of others. Thus we hypothesized that physicians, and especially surgeons, will mistrust this channel of patient education. This study was conducted to examine the attitude of orthopedic surgeons toward internet-educated patient.
Methods
This is a cross-sectional survey of nationally representative sample of orthopedic surgeons. We prepared a questionnaire about surgeons' attitude to their patients’ internet use which contained 12 closed questions, asking about: the percentage of patients who search the internet; referral of patients to different education sites; data quality; influence of internet-educated patient on physician's authority, doctor-patient relationship, patient's control perception and compliance, unnecessary tests and interventions and final health outcome. A questionnaire was administered to orthopedic surgeons, both board-certified and residents, during an annual National Orthopedic Association meeting. The questionnaire was offered to all the surgeons attending the meeting and they were aggressively urged to fill it. 201 surgeons filled the questionnaire. Their mean age was 46±11 years. 62 were residents (mean age 35±4 years) and 139 were attending surgeons (mean age 51±9 years). The later were 12±10 years after the board exams.
Results
83% of surgeons referred their patients to different internet sites, however 27% did it only rarely. 62% of surgeons felt that the quality of information is fair, 27% felt that the quality is good or excellent. Most of surgeons believed that internet does not jeopardize their authority (71%), doctor-patient relationship (77%), and patient's control perception (91%) and compliance (84%). However, 74% of surgeons were concerned that internet-educated patients are exposed to unnecessary tests and interventions. When examined by professional age (residents, young specialists, older specialists), an interesting trend is seen. Younger surgeons (residents and young specialists) rarely refer their patients to internet as opposed to older specialists (p<0.5). However, after 20 years experience, this trend stops. A similar trend is seen when asked about the data quality (p=0.08). 90% of surgeons wanted the National Orthopedic Association to develop a site that can serve as an "internet prescription" for patients' referral. 45% agreed to participate in this project, however only small minority supplied their connecting details.
Conclusions
In our study we found a positive attitude among orthopedic surgeons towards internet-educated patients. However, some overdiagnosis and overtreatment can happen. Younger and older surgeons are less internet-friendly, probably because of lower professional confidence in the first group and lower internet literacy in the second. National Orthopedic Associations can play an important role in preparing good-quality sites to be an "internet prescriptions" in different fields of orthopedic surgery.
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