Doctors googling patients is a commonly broken taboo
BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2301 (Published 18 October 2023) Cite this as: BMJ 2023;383:p2301
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Dear Editor
The GMC’s new guidance—Good medical practice 2024—emphasizes patient-centred care. In order to provide personalised care, the doctor requires to know about the patient. Such knowledge about what really matters to the patient can go far beyond information that patients may share in an outpatient consultation or a ward round. This unshared, silent information often relates to vulnerabilities that patients might find most difficult to speak about. Publicly available electronic information about the patient that can be accessed via Google may sometimes be useful in providing care that the patient really wants and needs. Patient targeted googling (PTG) can then be valuable tool in providing truly patient-centred care. Now PTG does not remain a taboo that the doctor requires to be able to justify breaking. Instead, might doctors be required to justify why they did not use PTG when it could have been critical for safeguarding and good care? The GMC requires to provide guidance urgently.
Competing interests: No competing interests
Targeted patient searching a complement, not a work around
Dear Editor
The article by Pavan Amara raises how the searching of patients is an unspoken taboo with limited guidance on when it may be appropriate. While a policy or guideline may aid clinicians, I would suggest reflecting on the the pillars of Medical ethics to guide whether it is appropriate or not.
If a clinician opts to Google a patient to aid their decision-making, this should be clearly documented in clinical notes and communicated to the patient. In the example of an adult performer with HIV, this would be justified by beneficence and non-maleficence. Changes in clinical care on this basis would have to be clearly communicated to maintain doctor-patient trust.
Furthermore, if a clinician searches for a patient and does not find any clinically relevant information, they should ensure that they take practical steps to minimise the reading of irrelevant information which may prejudice their views of the patient and thus alter their management. This should still be documented as a form of collateral history with a rationale for the search.
Any other form of patient searching is voyeurism, even if an attempt to humanise, and therefore unethical.
It must be remembered that all people, including clinicians, have a right to a private life and to choose what information they divulge to others. Searching for a patient should be used as a complementary approach, in specific cases, and not as a replacement for a well-managed consultation, built on mutual trust.
Competing interests: No competing interests