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Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service
Nyland Health Center, Biskopsgatan 1, SE-870 52 Nyland, Sweden.
Department of Otorhinolaryngology, Lund University, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2003 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, Vol. 5, no 4, e26- p.Article in journal (Other academic) Published
Abstract [en]

BACKGROUND: In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. OBJECTIVE: To study why individuals choose to consult previously-unknown doctors on the Internet. METHODS: Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" RESULTS: 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. CONCLUSIONS: We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

Place, publisher, year, edition, pages
2003. Vol. 5, no 4, e26- p.
Keyword [en]
Access to Information, Adolescent, Adult, Aged, Aged, 80 and over, Child, Confidentiality/trends, Delivery of Health Care/standards/trends, Female, Health Surveys, Humans, Information Services/trends, Internet/*trends, Male, Middle Aged, Patient Education as Topic/*trends, Public Health Informatics/trends, Remote Consultation/*trends, Sweden
National Category
Computer Science Family Medicine
URN: urn:nbn:se:umu:diva-11107DOI: 10.2196/jmir.5.4.e26PubMedID: 14713654OAI: diva2:150778
Available from: 2008-11-17 Created: 2008-11-17 Last updated: 2011-10-14Bibliographically approved
In thesis
1. Internet consultation in medicine: studies of a text-based Ask the doctor service
Open this publication in new window or tab >>Internet consultation in medicine: studies of a text-based Ask the doctor service
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to cast light on the new phenomenon of Internet-based medical consultation. This was approached by studies of the use of an Ask the doctor service, by a web survey to the users who sent enquiries to the service, and by a questionnaire to the answering physicians of their respective expericence of the service.

Written communication is becoming increasingly important, not only for communication between individuals outwith health care (e.g. by email, SMS and instant messaging), but also between doctors and patients. There is an ongoing shift in the way individuals look for medical information with an increasing number going first to the Internet berfore talking with their physicians. Also, there is an increasing interest from patients in accessing Internet-based services, including text-based consultations with doctors. These consultations can be part of the regular communication between a patient and his/her doctor or be carried out without any previous relationship. Our studies of the latter consultation type emanate from the free of charge Ask the doctor service at a Swedish public health web portal, Infomedica, financed by health authorities. At the Ask the doctor service, the communication has been merely text-based and the individual using the consultation service (here called the enquirer) might have been anonymous.

We followed the development of the first four years use of the service (38 217 enquiries), finding that the typical enquirer was a woman aged 21-60 years. Three quarters of the enquirers were women, thus exceeding the gender difference seen in regular health care. The service was used all times of the day and night, seven days a week, and it was most used in densely populated areas as defined from postal codes.

The enquiries submitted to the service included a broad variety of medical issues. Most enquirers asked on their own behalf. Almost half of the enquiries concerned a matter not previously evaluated by a medical professional. Only a few were frequent enquirers. The service was used e.g. for a primary evaluation of a medical problem, for getting more information on a medical issue under treatment, and for a second opinion. The most common reasons for turning to a doctor on the Internet were convenience, wish for anonymity and that doctors were experinced too busy. In free text a considerable number of participants expressed discontent and communication problems with a previous doctor as a reason to turn to the Ask the doctor service. Many participants expressed a view of the service as a complement to regular health care, and the majority were satisfied with the answer. Nearly half of the participants in the web survey stated that they received sufficient information in their answer and that they would not pursue their question further.

The family physicians answering the enquiries at the Ask the doctor service were stimulated and challenged by the new task, in spite of the limitations caused by the lack of personal meetings and physical examinations. The opportunity to reflect on the answer before replying was appreciated, and the task was regarded as having a high educational value for themselves.

The Internet not only allows easy access to medical information but also to medical consultation – to date mostly text-based. It is probable that in the near future an increasing number of doctors will adopt text-based communication via the Internet to be a natural part of their communication with patients. Therefore, training in text-based communication and carrying out Internet consultations should be integrated into the curricula of medical schools and of continuous professional development. Ethical guidelines should be established.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2006. 64 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1034
Internet, remote consultation, physician-patient relations, gender, access to information, ethics
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
medicinsk informatik
urn:nbn:se:umu:diva-854 (URN)91-7264-123-1 (ISBN)
Public defence
2006-10-06, Hörsal Betula, 6M, UMEÅ, 10:00 (English)
Available from: 2006-09-05 Created: 2006-09-05 Last updated: 2016-05-26Bibliographically approved

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