When do patients with hand illness seek online health consultations and what do they ask?
BACKGROUND
Several websites allow people to post health questions and get answers from doctors. Knowing more about what patients seek from these websites might help in-office educational efforts, but little is known about what occurs on these sites.


OBJECTIVE
This study addressed whether patients seeking advice online already have seen a physician, the type of questions asked, if they are dissatisfied with their doctor, the characteristics of the physicians who respond, and the content of their answers. This study documents the circumstances and content of questions asked about hand illness, the characteristics of the physician responders, and their responses.


METHODS
One hundred thirty-one hand surgery-related questions from an online health consultation website were reviewed retrospectively. The timing of and reason for the consultation, the content of the questions, the specialty of physician responder, and the content of the responses were recorded.


RESULTS
Sixty patients (46%) were seeking information before seeing a doctor, 21 (16%) after a medical encounter, and 19 (15%) after hand surgery. With increasing contact with providers, patient queries transitioned from diagnosis, to treatment, to prognosis, and potential complications. Patients who had seen a doctor often expressed dissatisfaction (16 of 37 patients [43%]) as did those who had hand surgery (seven of 26 patients [27%]). Between one and eight doctors (average, two) answered each query. Most of the answering physicians were hand surgeons. The information they provided predominantly addressed diagnosis.


CONCLUSIONS
Online consultations are most common among patients who have not seen a doctor, but also reflect uncertainty and dissatisfaction after seeing a doctor. Although online health consultations might support patients' quest for information and understanding, and the potential for multiple answers from different doctors creates the possibility for increased balance and breadth of opinions, the quality of the information and cost-effectiveness of this approach are uncertain and need to be evaluated carefully in future studies.
Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA, 02114, USA.
Jan Paul
JP
Briet
Michiel G
MG
Hageman
Robin
R
Blok
David
D
Ring
D022126:Access to Information; D032882:Comprehension; D006230:Hand Injuries / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D015438:Health Behavior; D063005:Health Information Systems; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D020407:Internet; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D009819:Office Visits; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011379:Prognosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D035501:Uncertainty