The Rise of the “Misguided” Online Consultation: Patient Expectations vs. Reality

“Blindness and Error can change a life as surely as Judgement and Reason can.”  ~ M. Morris

As social media and the internet in general take hold of almost every aspect of our lives, with their apparent ease of access and speed of response, we tend to infer that we can really do EVERYTHING in the virtual world. This notion has clearly spread throughout all fields of industry, marketing and certainly impacting the field of health services in general. In this blog post I’d like to discuss the downsides of people’s misguided perceptions that online medical/dental consultations are a viable and reliable form of enquiry into their health issues.

In this internet age of  the virtual Click and Get! mentality, most people seem to be unaware of the ramifications of relegating the answers to their important health-related questions to online Google searches and Instant Messages to any available online health care provider who would listen!

I’ve been witnessing this first-hand for a long time on almost a daily basis, as I review the barrage of dental and orthodontics-related questions through my clinic’s website and social media pages. Indeed these outlets have been set-up in the first place in order to facilitate contact between patients and their chosen healthcare providers, yet they have turned into means for what I like to call Misguided Online Consultations; where patients seem to expect a complete and thorough diagnosis with clear fee quotes regarding the procedures that THEY themselves have decided that they need! Many patients will literally “troll” – to use an internet-age term for this behavior – multiple dental clinic websites and social media pages until they get the response they’re looking for. Others are more sincere in their enquiries and genuinely seem to be looking for a professional opinion yet it can be also a struggle to inform them of the need of a proper clinical examination to be able to give any kind of accurate assessment of their situation.

Many patients also often tend to self-diagnose or relay a previous diagnosis from another doctor in a poor or inaccurate way. This makes it virtually impossible to give any kind of reasonable answer that would satisfy the enquiry at hand.

Some examples of such questions and enquiries include things such as:

• I’m 20 years old and I have an overbite and badly-shaped teeth. I need to do dental implants… (an example of self-diagnosis or inaccurate relay of a previous diagnosis?)
• My daughter is 10 years old and has protruding teeth… Is she ready for braces and how long will it take??
• I have a very small lower jaw and I was told I needed braces and Jaw surgery to fix it… I don’t want to have braces nor do any surgeries but I want it fixed. I was told  clear aligners can help (Really?!!!)…. How long would it take and what’s the cost??
• How much does a dental filling cost at your clinic??

This, I’m sure, is something that many dentists/orthodontists face as well. What most patients seem to fail to realize is that there is a high risk of receiving an incorrect diagnosis – and of course completely inaccurate fees quotes. The ease of access through Social media helps propagate this idea though it often results in Patient/Doctor misunderstandings down the line.

The main points patients need to understand and remember when asking for online consultations can be summarized as follows:

• There is no substitute for direct clinical – and often radiographic – examination in the vast majority of cases, for the clinician to be able to give an accurate diagnosis of a situation.
• General descriptions of many dental and orthodonics situations rarely provide enough accurate information for the clinician to make any kind of informed decisions about the situation at hand.
• Detailed procedures are impossible to assess nor explain online.
• Any quote for fees depends entirely on the existing clinical situation with its possible complications and nuisances that are impossible to assess by an online description from the patient.

The usual reply in such situations is to inform the patient that a proper assessment cannot be made with such limited information and that a clinical examination is required to give an accurate diagnosis.

It’s important for both patients and clinicians to understand the downsides and limitations of such an approach, and everyone would be better off adjusting their expectations in this regard.