Ethics of googling patients' names

[deleted307836]

I'm curious about this -- consider these two scenarios:

#1: You're an inpatient psychiatrist meeting with a patient for the first time. The patient makes statements to you that sound suspiciously grandiose. Among them, he says that he is a local surgeon. Would it be appropriate to google his name to verify this claim?

#2: You're an outpatient psychiatrist. Your patient admits committing a noteworthy crime in the past -- something that would certainly have made newspapers. You're curious about getting more information about this from the patient, but the patient doesn't want to talk about it further. Would it be appropriate to look this up on google to both verify this claim and to obtain further info?

Could these be HIPAA violations or otherwise ethical/privacy issues? Though it's doubtful anyone would find out, I think it's an interesting ethical question.

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[splik]

ffs this is not an ethical question. patients google us all the time. of course you can google patients. this has nothing to do with HIPAA (if you think this could be a violation you need to do your HIPAA training again) and has nothing to do with ethics. it is often good patient care. my hospital has a facebook account for this purpose and the social workers use it to see whether patients have made suicidal/homicidal statements. this has nothing to do with privacy either as all this information is in the public domain.

 

[deleted307836]

Thanks for your opinion. It's a topic that's been discussed in an ethical context in the past, at least from what I saw doing a search on the topic myself.

And yeah I realize the HIPAA thing probably isn't applicable. The only reason I thought it might be is if you don't delete your search history. If it's a communal computer at a hospital, for example, the patient's full name along with whatever they claimed would be in the search history.

 

[hamstergang]

ffs this is not an ethical question. patients google us all the time.

No, no. This is certainly an ethical question worth discussing. And the fact that patients do something to us has little bearing on whether we should do the same to them. For instance, patients rate us online, so we can do the same to them?

If you get information about a patient online, how do you think the patient would feel if they discovered this? It would certainly have an impact on the relationship you two have. So there should be a good reason for you to google the patient, and that reason had better be in the interest of the patient. To do so just for your own curiosity is wrong.

I've googled my patients maybe 4 times. Some were as in situation 1, to verify a patient's claim. I don't want to assume they're grandiose/delusional if I can find out otherwise. I've also done it to get a better sense of how psychotic the patient's been, what he's been doing with his time, by checking his facebook and seeing his crazy posting history (thankfully without homicidal statements due to his paranoia).

One last thing to consider is that when you visit a site, your computer's IP address can get saved as being a visitor. You want to be careful about leaving evidence that a psychiatric hospital/office was looking at a particular person's personal page somewhere.

 

[nitemagi]

I consider that which is on the internet to be in the public domain. It's available to the public. Therefore there's no privacy violation. Just as I feel OK if patients know things about me they can find on the internet. I don't add to that, but I recognize it's in the public domain and thus part of my public profile.

I would consider it a form of collateral information. There's no HIPAA violation as you are not passing out confidential information. You can always receive information from anyone.

If you believe it's an ethical violation (I do not), then which medical ethical principles does it violate???
Autonomy
Justice
Beneficence
Non-maleficense

 

[hamstergang]

If you believe it's an ethical violation (I do not), then which medical ethical principles does it violate???
Autonomy
Justice
Beneficence
Non-maleficense

If this negatively impacts your relationship with your patient, or sours them to psychiatry, you've done them harm. If the info you look up allows you to better help your patient, then this harm can be offset and I'd say the whole thing is ethically neutral. That's why I say it's ok to google your patient if it's in their interest and not just for your curiosity.

 

[nitemagi]

Any piece of information you gather could negatively impact your relationship with the patient. The burden is on you as a provider and what you do with the information. If you let it bias you, that's on you. If you use information to harm your patient, that's on you. It's your actions with information that could be ethically questionable, not the information itself.

I hear information all the time from a patient or family members or whomever could negatively impact the relationship (a family member leaves me a message telling me that the patient is lying to me and is really doing XYZ). I choose what to do with that information, with the goal of helping the person and their mental health.

I believe you have an obligation as a physician to use any data you have available to you. Deliberately avoiding data that could be helpful to someone's case (conceptualization, treatment choices, whatever) is not scientifically sound and automatically creates a bias. You can't cherry pick your data, if the data is out there.

Now we could have a separate discussion on the reliability of information available on the internet, but that's not about the ethics of it.

 

[hamstergang]

Any piece of information you gather could negatively impact your relationship with the patient.

But here, it's not about the information itself, it's about how the information is gathered. You don't think your patients would see a difference between info they give you, info their family gives you, and info you gather from online without their prior knowledge?

I believe you have an obligation as a physician to use any data you have available to you. Deliberately avoiding data that could be helpful to someone's case (conceptualization, treatment choices, whatever) is not scientifically sound and automatically creates a bias.

I think you need to make sure you're clearly stating that the info you gather is actually helpful to the case. Like I've said, if you're looking things up just for your own interest, that isn't helping you in the case at all and likely crosses a line. I think you should know in advance that the info will be helpful to the patient, answering a specific question you have.

 

[erg923]

I agree that there is no HIPPA issue here, only clinical ones. The most obvious: Why do you feel the need to google info about the person? Who benefits? Is this related to treatment/treatment planning? If not, then you might need to ask yourself why you feel compelled to do this? What is this about? My hunch is that, usually, this is much more about something thats going on with you than it is with them. In the above scenarios, #1 seems reasonable. #2 seems unnecessary unless that is somehow important for treatment (tx sexual offenders)

 

[nitemagi]

But here, it's not about the information itself, it's about how the information is gathered. You don't think your patients would see a difference between info they give you, info their family gives you, and info you gather from online without their prior knowledge?

Perhaps, perhaps not. I have plenty of patients who don't want their family members to leave me messages but they do anyways. The fact that the information is online is quite different than me going into their Facebook or hacking their email. We're talking about PUBLIC INFORMATION.

I think you need to make sure you're clearly stating that the info you gather is actually helpful to the case. Like I've said, if you're looking things up just for your own interest, that isn't helping you in the case at all and likely crosses a line. I think you should know in advance that the info will be helpful to the patient, answering a specific question you have.

Of course the goal should be to look for helpful information that is helpful to the case. You can have an active question, of course, but that doesn't mean you know what you'll find.

BUT, even if information was for your own curiosity, it's a BIG leap to say that's unethical, and that it causes damage to a person. That's a quite harder case to make. Again, this is info in the public domain. Can you really say that looking up information in the public domain causes damage to the patient?

Now what it says about you that you're looking things up for your own curiosity is something else, akin to a projective test (surely you don't google every patient, so what's so special about this one?).

 

[hamstergang]

You can keep focusing in the fact that this is public info, but that misses the point. Unlike listening to family members passively, going online is you actively seeking information the patient did not give you. Regardless of what it is actually is, to many patients this is mistrustful, creepy, and stalkerish. It harms the patient by how they perceive it, not by how you can rationalize it.

 

[nancysinatra]

You can keep focusing in the fact that this is public info, but that misses the point. Unlike listening to family members passively, going online is you actively seeking information the patient did not give you. Regardless of what it is actually is, to many patients this is mistrustful, creepy, and stalkerish. It harms the patient by how they perceive it, not by how you can rationalize it.

By your reasoning, wouldn't it then be "harmful" to utilize online state pharmacy monitoring programs where you can look up to see if a patient is doctor shopping to get multiple prescriptions for controlled meds? That information didn't come from the patient, and they may be very irritated to learn you have done that. (Both in cases where the patient is or is not doctor shopping.) It is information you "gather online without their prior knowledge." They may well find it "creepy, mistrustful, and stalkerish." It can certainly damage the therapeutic alliance. So then what is your opinion on those programs?

If this negatively impacts your relationship with your patient, or sours them to psychiatry, you've done them harm. If the info you look up allows you to better help your patient, then this harm can be offset and I'd say the whole thing is ethically neutral. That's why I say it's ok to google your patient if it's in their interest and not just for your curiosity.

Who gets to decide whether "infor you look up allows you to better help your patient?" And since when is it "ethically neutral" to "offset harm?" You just said that if you do something that negatively impacts your relationship with the patient, that you've harmed them. So move on. You've either harmed them or you haven't harmed them. I never heard of "offsetting" harm. Is this a concept you thought of yourself or is it an actual recognized ethics concept? I'm just asking - I actually don't know.

Or maybe it could be that the "relationship" with the patient is not the only thing that matters. Maybe it isn't always harmful to do things that "negatively impact" that relationship. Again, giving patients all the drugs they want and turning a blind eye to, say, drug diversion - that may help the "relationship" but it will harm the patient.

 

[nancysinatra]

I believe you have an obligation as a physician to use any data you have available to you. Deliberately avoiding data that could be helpful to someone's case (conceptualization, treatment choices, whatever) is not scientifically sound and automatically creates a bias. You can't cherry pick your data, if the data is out there.

Ok what if you live in a small town, and your patient is the mayor, and another patient of yours comments to you that he knows the mayor and the mayor is a hoarder living in extremely dangerous conditions and even creating a public health threat to the community. And let's say the mayor's house is not far from the hospital but it would be slightly out of your way to drive by it. Do you have an obligation to "use" the data you could get by driving by his house to see what it looks like?

Let's say it's not hoarding the second patient tells you the mayor doing. Instead say the second patient tells you the mayor is living in a mansion which he could only afford if he is embezzling money from the town. And let's say the mayor has complained of really bad anxiety, and feelings of guilt, and "paranoia" that he's going to "get in trouble." But he has never mentioned that he is stealing. Do you have an obligation to drive by in that situation? The exterior view of the house is public information after all, and you just said you can't cherry pick your data.

What if your patient the mayor lives in an out of the way location and you really have to make an effort to drive by - does that change your response in these scenarios?

I work in a small town and I face questions like these all the time. For example I have on a few occasions had one patient start talking about another patient, not knowing they're both my patients. I consciously avoid using that information, but it isn't always easy. Once the genie's out of the bottle, it's out.

 

[nancysinatra]

You can keep focusing in the fact that this is public info, but that misses the point. Unlike listening to family members passively, going online is you actively seeking information the patient did not give you. Regardless of what it is actually is, to many patients this is mistrustful, creepy, and stalkerish. It harms the patient by how they perceive it, not by how you can rationalize it.

Would you change your view on this if you were a forensic psychiatrist, asked to determine if a patient is malignering for disability, or if they were psychotic at the time they committed a crime?

 

[hamstergang]

By your reasoning, wouldn't it then be "harmful" to utilize online state pharmacy monitoring programs where you can look up to see if a patient is doctor shopping to get multiple prescriptions for controlled meds?

I feel my other posts have answered this (albeit indirectly). When you access this info, it's to answer a specific question to aid you in caring for the patient. Since it allows you to avoid fueling an addiction, it helps you help the patient, so it's fine.

And since when is it "ethically neutral" to "offset harm?" You just said that if you do something that negatively impacts your relationship with the patient, that you've harmed them. So move on. You've either harmed them or you haven't harmed them. I never heard of "offsetting" harm. Is this a concept you thought of yourself or is it an actual recognized ethics concept? I'm just asking - I actually don't know.

Sticking a needle in someone's arm harms them. Giving them IV antibiotics helps them. This benefit offsets the harm of the needle, making it ethical. I haven't heard others explicitly state this, but I think it's obvious we all believe it.

 

[nitemagi]

So to be clear, you believe there is an unspoken unwritten agreement (and expectation) by the patient that you will not look into publicly available information about them in the course of treating them, and that doing so is a violation of this agreement and their trust, as if they expect privacy about what's out there, and that they have control over what information a physician chooses to utilize in their care?

 

[deleted307836]

So to be clear, you believe there is an unspoken unwritten agreement (and expectation) by the patient that you will not look into publicly available information about them in the course of treating them, and that doing so is a violation of this agreement and their trust, as if they expect privacy about what's out there, and that they have control over what information a physician chooses to utilize in their care?

I think hamnstergang has made it clear that the physician's intent makes the difference. If it is clearly relevant to their care, then no problem.

But what about someone who googles all of their patients for the heck of it, just to see what they can find? Of course that reflects on them as a person and as a physician, however it seems a stretch to me to say it is in no way a privacy violation. I would extremely weirded out if one of my doctors googled me and started reading all of the obituaries in which I am mentioned as a surviving family member, looking at my tweets, seeing what part of town I lived in, etc. since it would in no way ever be relevant to the care I receive from that physician. I would consider that a breach of trust despite the information being publicly available, since I could only personally assume that the physician's intent in doing so isn't positive.

This is all hypothetical since I personally make it very difficult for anyone to find information about me, which is probably the best approach for any student or healthcare professional.

 

[nitemagi]

CityLights, I agree that the intent is important. I just take issue with selfish intent being "unethical." All too often I hear unethical thrown around when really it's a different issue. Ethics have specific parameters and I think the case is much harder to make that having selfish intent in googling vs. clinical interest causes "Harm" to a patient. Not impossible, but a much harder case to make. Selfish intent has the possibility of being a slippery slope that leads to poor care if the needs of the patient are de-prioritized, but then that's a dereliction of duty during clinical care, rather than an ethical violation from an internet search.

 

[nancysinatra]

I feel my other posts have answered this (albeit indirectly). When you access this info, it's to answer a specific question to aid you in caring for the patient. Since it allows you to avoid fueling an addiction, it helps you help the patient, so it's fine.


Sticking a needle in someone's arm harms them. Giving them IV antibiotics helps them. This benefit offsets the harm of the needle, making it ethical. I haven't heard others explicitly state this, but I think it's obvious we all believe it.

I though this was just an interesting discussion about how people viewed this. I don't think it is "obvious" that everyone believes anything. Sorry though, if I offended you, although I'm not entirely convinced by your argument, despite the fact that it has some compelling points.

The needlestick example is interesting but I'm not sure it is adequate to illustrate some general, widespread priniciple of "harm offset," espeically not as applies to emerging technologies. You are assuming that a briefly painful procedure is a decent example of "harm." Ok for an infant I would agree. Similarly in veterinary medicine. And dentistry must be full of examples like this. But most adults are pretty ok with the momentary pain of a needlestick. The benefits of the antibiotics are easy to quantify and rationalize, which is not the case in much of psychiatry. For example, the polio vaccine I received as a child has lowered my risk of polio by a quantifiable amount over an extensive period of time, and polio itself is a disease with a well known natural history, a known mortality rate, and really no effective treatments, and in addition, the vast majority of human beings have an unambiguous desire NOT to get polio, and for those who DO want to get polio, society has pretty much overruled them. Drug addiction is very different, as the patient is both the agent and the host of the disease. Many patients are not motivated to overcome addiction and would very much resent your looking them up on the pharmacy register. Society has also not said umanmbiguosly that we want to treat addiction. Drug addiction is not entirely understood in terms of the physiology or epidemiology.

Even vaccines are considered controversial by many people. And the "harm offset" was not decided by one person.

So in the end, it's your judgment and no more that there is "harm offset" when you use the state pharmacy program. Whereas the patient might not agree at all. Maybe the public would look at the pharmacy register and decide it is creepy. Maybe the ACLU would would look at it and see "government surveillance." Who knows?

I think a better way to look at this is risks - benefits analysis. The risk of googling your at patient is that you creep them out and damage the relationship. But what if they never find out? Or what if they don't find it creepy?

 

[nancysinatra]

CityLights, I agree that the intent is important. I just take issue with selfish intent being "unethical." All too often I hear unethical thrown around when really it's a different issue. Ethics have specific parameters and I think the case is much harder to make that having selfish intent in googling vs. clinical interest causes "Harm" to a patient. Not impossible, but a much harder case to make. Selfish intent has the possibility of being a slippery slope that leads to poor care if the needs of the patient are de-prioritized, but then that's a dereliction of duty during clinical care, rather than an ethical violation from an internet search.

I agree - I think "unethical" is not really the right word here.

Even if a doctor is totally creepy and googles all their patients for no good reason - how is that an ethics issue? It's just a human-nature-meets-new-technology issue. The internet makes the "creepy" behavior easier to engage in. That same doctor could have been going down to the public library 20 years ago and getting the same information. The effort required would have probably prevented a lot of doctors from doing that. But nowadays, everyone can be a "stalker." So what should be done about that?

 

[nancysinatra]

You can keep focusing in the fact that this is public info, but that misses the point. Unlike listening to family members passively, going online is you actively seeking information the patient did not give you. Regardless of what it is actually is, to many patients this is mistrustful, creepy, and stalkerish. It harms the patient by how they perceive it, not by how you can rationalize it.

It seems like you are assuming the patients feel the same way you might feel. But there is a spectrum of how people regard "privacy." I had a patient scheduled a few months ago who called our clinic in advance and demanded that I never open her past chart, because it would be "an invasion of her privacy" to do that. (She had previously been diagnosed with a personality disorder, and was angry. She didn't want me to become biased by that.) I refused to see that patient because not looking over her record could expose me to undue medical risk. But I doubt she saw it that way.

 

[hamstergang]

It seems like you are assuming the patients feel the same way you might feel.

Nope, not at all. I just don't assume everyone thinks like me.

I don't have time now to get to your other post in detail, but a needlestick is undoubtedly a harm. It hurts and opens you up to infection. I don't get how this could be debatable.

 

[Armadillos]

I would argue that in cases where a patient is making claims you find grandiose and/or delusional, but are still in the realm of possibility its almost unethical not to google them.

 

[nancysinatra]

Nope, not at all. I just don't assume everyone thinks like me.

I don't have time now to get to your other post in detail, but a needlestick is undoubtedly a harm. It hurts and opens you up to infection. I don't get how this could be debatable.

Infection is a risk, not guaranteed. The pain is different for each person, so there is a risk of pain. The risk of pain is high, but the amount is usually small. Even then there has to be a benefit to the needlestick, such as getting antibiotics.

Medical ethics uses a "sliding scale" when it comes to patients' capacity to consent or refuse treatments. Both the importance of the procedure and its potential for harm are considered in deciding if a patient lacks capacity.

You're saying that Googling someone will cause harm in the form of damaging the therapeutic relationship. How MUCH harm will that cause? What is the likelihood? If you can't quantify the harm or predict its likelihood, then how can you know if you are "offsetting" it? How can you do a meaningful risk-benefit analysis? You don't even know what you're looking "for" when you start the search.

Risk-benefit analyses and the decisions made based on them are supposed to include the patient. It's not just the doctor sitting there making all the decisions. In this scenario, though, with the pharmacy register and its prospect for damaging the therapeutic alliance, YOU are making all the decisions.

What I would argue is that based on your reasoning above, that secretly looking up the patient the pharmacy register is unethical. That is because you have likened the online search to a "procedure" while depriving the patient of their right to refuse the "intervention" and without formally assessing their capacity to do so.

I don't think the pharmacy register is unethical, so I would reject your reasoning. I would say instead that Googling patients might be creepy, but it is not "unethical."

 

[shan564]

I consider that which is on the internet to be in the public domain. It's available to the public. Therefore there's no privacy violation. Just as I feel OK if patients know things about me they can find on the internet. I don't add to that, but I recognize it's in the public domain and thus part of my public profile.

I would consider it a form of collateral information. There's no HIPAA violation as you are not passing out confidential information. You can always receive information from anyone.

This is what I was going to say. If it's on the Internet, it's publicly available to everybody, so reading it is no form of violation of anything. If you think that a piece of information is relevant to your treatment, then it's part of beneficence. My state has a website where you can look up court records, and we routinely use this information to aid in our assessment/treatment.

If this negatively impacts your relationship with your patient, or sours them to psychiatry, you've done them harm. If the info you look up allows you to better help your patient, then this harm can be offset and I'd say the whole thing is ethically neutral. That's why I say it's ok to google your patient if it's in their interest and not just for your curiosity.

By that logic, you also shouldn't involuntarily commit people or give them PRN Haldol/Ativan or call them out when they're lying to you about their drug test...

 

[hamstergang]

Infection is a risk, not guaranteed. The pain is different for each person, so there is a risk of pain. The risk of pain is high, but the amount is usually small. Even then there has to be a benefit to the needlestick, such as getting antibiotics.

Medical ethics uses a "sliding scale" when it comes to patients' capacity to consent or refuse treatments. Both the importance of the procedure and its potential for harm are considered in deciding if a patient lacks capacity.

You're saying that Googling someone will cause harm in the form of damaging the therapeutic relationship. How MUCH harm will that cause? What is the likelihood? If you can't quantify the harm or predict its likelihood, then how can you know if you are "offsetting" it? How can you do a meaningful risk-benefit analysis? You don't even know what you're looking "for" when you start the search.

Risk-benefit analyses and the decisions made based on them are supposed to include the patient. It's not just the doctor sitting there making all the decisions. In this scenario, though, with the pharmacy register and its prospect for damaging the therapeutic alliance, YOU are making all the decisions.

What I would argue is that based on your reasoning above, that secretly looking up the patient the pharmacy register is unethical. That is because you have likened the online search to a "procedure" while depriving the patient of their right to refuse the "intervention" and without formally assessing their capacity to do so.

I don't think the pharmacy register is unethical, so I would reject your reasoning. I would say instead that Googling patients might be creepy, but it is not "unethical."

You are completely missing the point. My example of the needlestick was supposed to be just a simple example of how benefit can outweigh harm. This is a non-controversial concept. Look at what surgeons do. Those procedures are incredibly harmful, but the benefits provided allow them to be ethical. Don't take this to be an analogy or anything -- it's simply to illustrate the concept and show you that you already accept this concept.

You're saying that Googling someone will cause harm in the form of damaging the therapeutic relationship. How MUCH harm will that cause? What is the likelihood? If you can't quantify the harm or predict its likelihood, then how can you know if you are "offsetting" it? How can you do a meaningful risk-benefit analysis? You don't even know what you're looking "for" when you start the search.

What this line of questioning points out is that there are considerations you should take before googling a patient. There is no clear right or wrong that applies in all cases. As a physician, you have to weigh both sides and come to what you believe to be the ethical decision. It's part of what being a doctor entails, and it's why we have ethics courses in medical school and residency (in mine, at least).

By that logic, you also shouldn't involuntarily commit people or give them PRN Haldol/Ativan or call them out when they're lying to you about their drug test...

This is such a frustrating thread. Several posts already have addressed a single thing I've said while ignoring all the rest, thereby creating a strawman. This tactic isn't conducive to a productive discussion. Go back and actually read my posts. If you still don't see how I've already addressed this point you're making, then ask and I'll spell it out for you. (edit: in fact, you only have to re-read the portion of my post that you quoted. I explain there exactly what's wrong with your example.)

 

[David Hume]

Whether or not to google a patient is absolutely a matter of debate in the ethical and clinical domains. A group of psychiatrist-ethicists wrote a great paper on this a few years ago and even coined the term, "Patient-targeted googling (PTG)." See below.

You may or may not agree with their positions, but saying that it is universally acceptable to google a patient in all circumstances for any reason because the information exists in the public domain (and therefore, this is not an ethical dilemma) is false.

http://informahealthcare.com/doi/abs/10.3109/10673221003683861

 

[nitemagi]

Whether or not to google a patient is absolutely a matter of debate in the ethical and clinical domains. A group of psychiatrist-ethicists wrote a great paper on this a few years ago and even coined the term, "Patient-targeted googling (PTG)." See below.

You may or may not agree with their positions, but saying that it is universally acceptable to google a patient in all circumstances for any reason because the information exists in the public domain (and therefore, this is not an ethical dilemma) is false.

I'm not sure anyone wrote it's universally acceptable, but rather that the issue is not inherently an ethical dilemma. I could ask my patient about their financial situation with an intent to exploit them, and that would again clinical misconduct. That doesn't make talking to my patient an inherently ethical or unethical issue.

I think this is tempting to people to discuss because it's "new," as if technology has really opened up all these novel ethical areas. They are really minor iterative changes in the usual.

 

[psych md jd]

"Would you change your view on this if you were a forensic psychiatrist, asked to determine if a patient is malignering for disability, or if they were psychotic at the time they committed a crime?"

When I conduct a forensic evaluation, I advise the subject that I am not his/her doctor, I am not treating him/her, and that I am here at the request of the court (or attorney, or employer) to conduct an evaluation, and that there is no confidentiality. I have no doctor-patient relationship with the subject. Information from any source is fair game.

 

[Jorje286]

I do think it's an issue of ethics. Whenever one is dealing with right/wrong formulation, you're dealing with ethics. I'd say if you're googling patient information because of "interest" then probably it's unethical, because it may be in conflict with patient care. However, it's really more tricky than this because one can argue any piece of information is actually of benefit to the physician if he/she chose to use it that way. Facebook, twitter..etc is another window on the patient's personality which you may not be able to pick in a 30 minute interview. Where's the line though? that's a tough question and it's obviously not a thick one. On the question of confidentiality, most people open up facebook accounts to be in continuing contact with people they know already. So I don't think you can totally dismiss some sort of privacy because information is in the public domain.

 

[billypilgrim37]

If you're not looking up your adolescent patients on facebook at least every once in a while, you probably can't do your job as well as you could be.

Kids coming to see the psychiatrist seem to be the least likely to understand the whole concept of privacy settings.

 

[deleted500612]

I agree that there is no HIPPA issue here, only clinical ones. The most obvious: Why do you feel the need to google info about the person? Who benefits? Is this related to treatment/treatment planning? If not, then you might need to ask yourself why you feel compelled to do this? What is this about? My hunch is that, usually, this is much more about something thats going on with you than it is with them. In the above scenarios, #1 seems reasonable. #2 seems unnecessary unless that is somehow important for treatment (tx sexual offenders)

What about for your own safety as a practitioner? In #2 if the patient says they murdered someone a few years ago, wouldn't it be useful to know the circumstance for your own safety? Or to know if they spent time in prison for it? Maybe they never even got caught. Maybe the person he murdered 10 years ago was his psychiatrist when he didn't like the meds they gave him. I realize this is perhaps a far-fetched plot line, but since this whole thread is about hypotheticals I am genuinely curious.

 

[Caldwell-Luc]

Maybe it is just me, but I think one has to be pretty bored to go looking up their patients.

It is creepy behavior.

There was a situation with a classmate/friend who was in therapy because she used to google people, call around and get info about people, and in person ask about others, etc. I know calling around is MUCH worse, but in her case she wasted a lot of time engaging herself in snooping behavior. It interfered with her life. Now imagine engaging in similar type of behavior while treating a patient for this (although, the chances are rare). Calling around is MUCH worse. But, even if the info is available online, it is the idea of finding info about others that makes it almost the same.

Anyway, it just seems like a waste of time.

 

[SteinUmStein]

We've had a patient whose claims sounded basically psychotic and delusional with a touch of narcissistic personality disorder until our attending finally googled him - yep, it was all true. Nobody believed it until we saw the multiple news articles about this person's work.

 

[birchswing]

As a patient, I would welcome a practitioner taking that level of interest—I would also find it unfathomable that one would when they usually cannot even remember your name, let alone Google it!

I Google my doctors and look up their medical licenses and see if they have any paid claims. My last psychiatrist had an open Facebook page so that I could see his posts. He apparently hates all Southerners and lives in the South. I didn't care, though. I did, however, start to question his intelligence. If it's not clear from his command of the English language, he was an FMG (in this case from Pakistan). He had a bad anger problem (to the point you would hear him screaming), and then eventually quit without telling me, so I've moved on to greener pastures anyway.

To wit regarding his intelligence (regarding a giraffe being put to death in a zoo):

Sacrificing a giraffe because of not so good genes. Dear God. I thought the world did away with eugenics and perfection of the Aryan race. This is Nazism reborn. Star Trek was way ahead of its time with the Borgs: "Resistance is futile. You will be assimilated." In this case to the Lions. Hail Caesar.

And the one about Southerners:

ya'll so stupid

so now engaging in Libya is an impeachable offense? When were the politicians when Bush did water boarding? Shouldnt he be tried for war crimes? Come on...stop be so hypocritical.

And all those people that dont want mandatory health care...mainly from the south...toothless and obese...so no next time your fat belly hurts DO not go to the ER>>>may be u have an acute abdomen because u swallowed a loose tooth that got stuck in the ileocecal valve...ya'll so STUPID

 

[slappy]

I do this all the time the situation calls for it. It's no ethical dilemma to me.

 

[erg923]

I do this all the time. It's no ethical dilemma to me.

Why?

 

[notdeadyet]

Maybe it is just me, but I think one has to be pretty bored to go looking up their patients.

It is creepy behavior.

Cyberstalking your patients is creepy. Doing due diligence for the sake of diagnosis and/or treatment not only isn't creepy, it's standard of care. A patient thin disheveled patient who reports having anorexia and being an ex-90s supermodel is either telling the truth or fabricating. If you believe her at face value without checking collateral (including the Internet) and you're wrong, you may be missing a psychotic disorder and do your patient poor service. If you think she's lying and you're wrong, you may be treating AN when in fact you're missing psychosis. There are LOTS of true stories like this. You need to check collateral sources at hand, and if this includes the Internet, so be it.

This is VERY different from a private practice psychiatrist looking up his generalized anxiety patient on Facebook to see what she's up to. That is creepy.

Like most things brought up on this forum that many members try to make black and white, it's actually an "it depends" with shades of gray.

 

[Caldwell-Luc]

Birchswing said

"As a patient, I would welcome a practitioner taking that level of interest—I would also find it unfathomable that one would when they usually cannot even remember your name, let alone Google it!"

Yes, I really know what you mean. I had a psychiatrist that ran his practice like a factory (term used on these threads). I went to a day treatment program where several of us had him as a doctor. We discussed him a little, and it seemed like he remembered names, but never was interested in anything people told him. So, in a way, it is flattering for a provider to be that interested.

As far as everyone else on this thread, how are you finding soo much info about patients online. I was told that many people do not leave a lot of info about themselves out there. Even with facebook, people tend to be very careful about what others can view.

If you were to do an online search on me, nothing comes up because I am careful about privacy. I am sure that many others do this.

 

[erg923]

As far as everyone else on this thread, how are you finding soo much info about patients online. I was told that many people do not leave a lot of info about themselves out there. Even with facebook, people tend to be very careful about what others can view.

If you were to do an online search on me, nothing comes up because I am careful about privacy. I am sure that many others do this.

Uh, no. Exactly the opposite.

 

[birchswing]

Birchswing said

"As a patient, I would welcome a practitioner taking that level of interest—I would also find it unfathomable that one would when they usually cannot even remember your name, let alone Google it!"

Yes, I really know what you mean. I had a psychiatrist that ran his practice like a factory (term used on these threads). I went to a day treatment program where several of us had him as a doctor. We discussed him a little, and it seemed like he remembered names, but never was interested in anything people told him. So, in a way, it is flattering for a provider to be that interested.

But how are you finding soo much info about patients online. I was told that many people do not leave a lot of info about themselves out there. Even with facebook, people tend to be very careful about what others can view.

If you were to do an online search on me, nothing comes up because I am careful about privacy. I am sure that many others do this.

I am very surprised at the number of educated people who leave their Facebook wide open. I'm not even sure how it happens because for a while Facebook was even walking you step-by-step on how to make everything private. I check mine from time to time by logging out and then typing in the URL of my Facebook account to make sure nothing shows up and also searching for myself through another fake account. That's my way of doing it, but I'm sure there are others. But as I said, my previous psychiatrist has everything public for whatever reason.

 

[Caldwell-Luc]

I am very surprised at the number of educated people who leave their Facebook wide open. I'm not even sure how it happens because for a while Facebook was even walking you step-by-step on how to make everything private. I check mine from time to time by logging out and then typing in the URL of my Facebook account to make sure nothing shows up and also searching for myself through another fake account. That's my way of doing it, but I'm sure there are others. But as I said, my previous psychiatrist has everything public for whatever reason.

That is a good idea. That's interesting that your psychiatrist would leave everything open. Usually a provider would be worried about what patients and colleagues learn.