Why patients go online: multiple sclerosis, the internet, and physician-patient communication.

BACKGROUND: The online information seeking of multiple sclerosis (MS) patients, their reasons for doing so, and its importance for physician-patient communication have not been described. METHODS: Patients (n = 61) presenting for the first time at an MS clinic from December 2003 to July 2005 were interviewed pre- and postappointment and administered standard measures of pain and health quality of life. Consultations were audio recorded. Quantitative data were analyzed in light of qualitative data. RESULTS: Eighty-two percent of patients reported gathering medical information online before their first appointment; 36% discussed this information with their physician. Qualitative reasons for Internet information seeking and for not communicating it show some signs of wariness of health care potentially leading to nonadherence. CONCLUSIONS: Most MS patients are informed by online information, but are unlikely to discuss that research with physicians for reasons that may have implications for patient adherence.

Working the waiting room: managing fear, hope, and rage at the clinic gate.

In this article, we outline the contrasting perspectives of patients and receptionists and the different ways they experience waiting rooms in three U.S. medical clinics. We are doing this to show that a consideration of waiting rooms and the receptionists who work there is an important step in understanding the patient care-seeking experience. We describe the kinds of conflicts that emerge around patient waiting and the emotional labor that receptionists perform to reduce these conflicts by managing patient feelings. By doing this we expand the frame of the clinic visit to include the emotionally important space of the waiting room and revisit the concept of "emotional labor" as a way to understand non-medical care giving in clinic settings and the cultivation of emotions in others. In doing so we show the important role that clinic receptionists may play in shaping how and when patients receive health care.

Prepared patients: internet information seeking by new rheumatology patients.

OBJECTIVE: To investigate to what extent and why new rheumatology patients access medical information online prior to first appointments and secondarily to ask whether they discuss information gained from the Internet with physicians. METHODS: Research was conducted in a teaching rheumatology clinic with a nonrandom sample of 120 English-speaking adults presenting for first appointments in rheumatology. Quantitative and qualitative data were gained in pre- and postappointment patient surveys and interviews, including online information gathering prior to first appointment, demographics, health status, information usage in patient-physician interactions, and satisfaction. Data were analyzed for significant relationships across variables and for qualitative insights into quantitative outcome measures. RESULTS: Of all patients, 87.5% looked up their symptoms or suspected condition prior to their first appointment and 62.5% of all patients sought that information on the Internet. Only 20% of online information seekers discussed that information with their physicians. Age and sex were significant predictors of Internet information seeking. Physician and patient appointment satisfaction was significantly higher when Internet information was discussed; however, most patients did not discuss their information seeking because they primarily feared being perceived as challenging their physician. CONCLUSION: The majority of patients research their conditions online prior to initial appointments, but are unlikely to discuss that research with physicians even though discussion is related to higher satisfaction. Physicians may want to consider strategies for enabling communication about online research.