‘We all have friends like that’

How Australian patients avoid Dr Google shame


  • Lucinda Roper Royal Darwin Hospital
  • Nancy Sturman University of Queensland




Dr Google, internet health information, patient-centred care, patient–doctor communication, patient–doctor relationship


Medical professionals are in an ideal position to mediate between the benefits and harms of internet-sourced medical information, but there is reluctance by patients to discuss with their doctors information found online. This is the first study undertaken in a rural Australian context, where service limitations mean patients’ use of the internet may be especially important. Patients attending general practice clinics (n = 33) were interviewed to discover how they used the internet for health information and how they discussed this with their doctors. Analysis used a constant comparison method, informed by grounded theory and a dramaturgical framework. Most participants used a range of tactics when discussing internet-sourced medical information, including concealment, disguise or upfront apologetic disclosures to avoid undermining the expertise of the doctor. These findings do not confirm predictions made in the past that patients’ acquisition of internet health information would alter the power dynamic of the medical consultation. Potentially, proactive, doctor-initiated inquiry about internet medical information may help to normalise patients’ internet use, allowing open discussion, so doctors can maximise benefits and reduce harms of internet health information. Further study is required to see if this will be an effective strategy and impact health outcomes.

Author Biographies

Lucinda Roper, Royal Darwin Hospital

Lucinda Roper is a junior doctor working in Australia. She has a key interest in patient–doctor communication and how technology might alter the patient–doctor relationship.

Nancy Sturman, University of Queensland

Nancy Sturman is a general practitioner and Associate Professor with an interest in homelessness and addiction medicine. Her research interests include ethical issues and professionalism in general practice, vulnerable populations, ethical reasoning and professionalism in medical education, and trainee-initiated oversight, support and advice in general practice training. She is currently undertaking a PhD in medical education, focused on GP registrar-initiated ad hoc oversight, support and advice in general practice specialty training.


Ahluwalia, Sanjiv, Elizabeth Murray, Fiona Stevenson, Cicely Kerr and Jo Burns (2010) ‘A heartbeat moment’: Qualitative study of GP views of patients bringing health information from the internet to a consultation. British Journal of General Practice 60 (571): 88–94. https://doi.org/10.3399/bjgp10X483120

Ahmad, Farah, Pamela L. Hudak, Kim Bercovitz, Elisa Hollenberg and Wendy Levinson (2006) Are physicians ready for patients with internet-based health information? Journal of Medical Internet Research 8 (3): Art. e22. https://doi.org/10.2196/jmir.8.3.e22

Amsbary, Jonathan H. and Larry Powell (2018) Interviewing in a Changing World: Situations and Contexts. New York: Routledge. https://doi.org/10.4324/9781315113135

Bianco, Aida, Rossella Zucco, Carmelo Giuseppe A. Nobile, Claudia Pileggi and Maria Pavia (2013) Parents seeking health-related information on the Internet: Cross-sectional study. Journal of Medical Internet Research 15 (9): Art. e204. https://doi.org/10.2196/jmir.2752

Bloor, Michael J. and Gordon W. Horobin (1975) Conflict and conflict resolution in doctor/patient interactions. In Adrianne Mead and Caroline Cox (eds) A Sociology of Medical Practice, 271–284. London: Collier-Macmillan.

Bowes, Parvathy, Fiona Stevenson, Sanjiv Ahluwalia and Elizabeth Murray (2012) ‘I need her to be a doctor’: Patients’ experiences of presenting health information from the internet in GP consultations. British Journal of General Practice 62 (604): e732–e738. https://doi.org/10.3399/bjgp12X658250

Broom, Alex (2005) Virtually [email protected]: The impact of internet use on disease experience and the doctor–patient relationship. Qualitative Health Research 15 (3): 325–345. https://doi.org/10.1177/1049732304272916

Bundy, Alan (ed.) (2004) Australian and New Zealand Information Literacy Framework: Principles, Standards and Practice (2nd edition). Adelaide: Australian and New Zealand Institute for Information Literacy.

Cassell, Catherine and Gillian Symon (2004) Essential Guide to Qualitative Methods in Organizational Research. New York: Sage. https://doi.org/10.4135/9781446280119

Charmaz, Kathy (2006) Constructing Grounded Theory: A Practical Guide through Qualitative Analysis. New York: Sage.

Chiu, Yu-Chan (2011) Probing, impelling, but not offending doctors: The role of the internet as an information source for patients’ interactions with doctors. Qualitative Health Research 21 (12): 1658–1666. https://doi.org/10.1177/1049732311417455

Chung, Jae Eun (2013) Patient–provider discussion of online health information: Results from the 2007 Health Information National Trends Survey (HINTS). Journal of Health Communication 18 (6): 627–648. https://doi.org/10.1080/10810730.2012.743628

Cocco, Anthony M., Rachel Zordan, David McD Taylor, Tracey J. Weiland, Stuart J. Dilley, Joyce Kant, Mahesha Dombagolla, Andreas Hendarto, Fiona Lai and Jennie Hutton (2018) Dr Google in the ED: Searching for online health information by adult emergency department patients. Medical Journal of Australia 209 (8): 342–347. https://doi.org/10.5694/mja17.00889

Coulter, Angela (1999) Paternalism or partnership? Patients have grown up – and there’s no going back. British Medical Journal 319 (7212): 719–720. https://doi.org/10.1136/bmj.319.7212.719

Daymon, Christine and Immy Holloway (2010) Qualitative Research Methods in Public Rela­tions and Marketing Communications. New York: Routledge. https://doi.org/10.4324/9780203846544

Diaz, Joseph A., Rebecca A. Griffith, James J. Ng, Steven E. Reinert, Peter D. Friedmann and Anne W. Moulton (2002) Patients’ use of the internet for medical information. Journal of General Internal Medicine 17 (3): 180–185. https://doi.org/10.1046/j.1525-1497.2002.10603.x

Ellis, Chris, Brian Vans, Giselle Santiago and Leticia Reed (2007) Surveying international travelers: An argument for intercept interviewing. Paper presented at the American Association for Public Opinion Research 62nd Annual Conference, 17–20 May, Anaheim, CA.

Fage-Butler, Antoinette Mary and Matilde Nisbeth Jensen (2015) The relevance of existing health communication models in the email age: An integrative literature review. Communication & Medicine 12 (2–3): 117 –128. https://doi.org/10.1558/cam.18399

Francis, Karen (2012) Health and health practice in rural Australia: Where are we, where to from here? Online Journal of Rural Nursing and Health Care 5 (1): 28–36. https://doi.org/10.14574/ojrnhc.v5i1.188

Goffman, Erving (1959) The Presentation of Self in Everyday Life. Garden City, NY: Doubleday.

Goffman, Erving (1974) Frame Analysis: An Essay on the Organization of Experience. New York: Harper and Row.

Hart, Angie, Flis Henwood and Sally Wyatt (2004) The role of the internet in patient-practitioner relationships: Findings from a qualitative research study. Journal of Medical Internet Research 6 (3): Art. e36. https://doi.org/10.2196/jmir.6.3.e36

Hay, M. Cameron, R. Jean Cadigan, Dinesh Khanna, Cynthia Strathmann, Eli Lieber, Roy Altman, Maureen Mcmahon, Morris Kokhab and Daniel E. Furst (2008) Prepared patients: Internet information seeking by new rheumatology patients. Arthritis Care & Research 59 (4): 575–582. https://doi.org/10.1002/art.23533

Hay, M. Cameron, Cynthia Strathmann, Eli Lieber, Kimberly Wick and Barbara Giesser (2008) Why patients go online: Multiple sclerosis, the internet, and physician-patient communication. The Neurologist 14 (6): 374–381. https://doi.org/10.1097/NRL.0b013e31817709bb

Henwood, Flis, Sally Wyatt, Angie Hart and Julie Smith (2003) Ignorance is bliss sometimes: Constraints on the emergence of the ‘informed patient’ in the changing landscapes of health information. Sociology of Health & Illness 25 (6): 589–607. https://doi.org/10.1111/1467-9566.00360

Ieraci, Susan (2018) Redefining the physician’s role in the era of online health information. Medical Journal of Australia 209 (8): 340–341. https://doi.org/10.5694/mja18.00652

Imes, Rebecca S., Carma L. Bylund, Christina M. Sabee, Tracy R. Routsong and Amy Aldridge Sanford (2008) Patients’ reasons for refraining from discussing internet health information with their healthcare providers. Health Communica­tion 23 (6): 538–547. https://doi.org/10.1080/10410230802460580

Kivits, Joëlle (2006) Informed patients and the internet: A mediated context for consultations with health professionals. Journal of Health Psychology 11 (2): 269–282. https://doi.org/10.1177/1359105306061186

Langstrup, Henriette and Anja Elkjær Rahbek (2015) Conceptualizing ‘role’ in patient-engaging e-health: A cross-disciplinary review of the literature. Communication & Medicine 12 (2–3): 129–143. https://doi.org/10.1558/cam.31817

Mayo Clinic Social Media Network (2019) Mayo Clinic Social Media Fellows Program. Available online: https://socialmedia.mayoclinic.org/social-media-fellows-program/

McMullan, Miriam (2006) Patients using the internet to obtain health information: How this affects the patient–health professional relationship. Patient Education and Counseling 63 (1): 24–28. https://doi.org/10.1016/j.pec.2005.10.006

Mills, Jane, Ann Bonner and Karen Francis (2006) The development of constructivist grounded theory. International Journal of Qualitative Methods 5 (1): 25–35. https://doi.org/10.1177/160940690600500103

Murray, Elizabeth, Bernard Lo, Lance Pollack, Karen Donelan, Joe Catania, Martha White, Kinga Zapert and Rachel Turner (2003) The impact of health information on the internet on the physician-patient relationship: Patient perceptions. Archives of Internal Medicine 163 (14): 1727–1734. https://doi.org/10.1001/archinte.163.14.1727

Nettleton, Sarah, Roger Burrows and Lisa O’Malley (2005) The mundane realities of the everyday lay use of the internet for health, and their consequences for media convergence. Sociology of Health & Illness 27 (7): 972–992. https://doi.org/10.1111/j.1467-9566.2005.00466.x

Pilnick, Alison and Robert Dingwall (2011) On the remarkable persistence of asymmetry in doctor/patient interaction: A critical review. Social Science & Medicine 72 (8): 1374–1382. https://doi.org/10.1016/j.socscimed.2011.02.033

Roberts, Celia and Srikant Sarangi (2019) Third party insurance? Interactional role alignment in family member mediated primary care consultations. Communication & Medicine 15 (2): 191–205. https://doi.org/10.1558/cam.38675

Roper, Lucinda and Christine Jorm (2017) ‘Please leave your phone outside’: Policymakers and medical app providers are encouraging patient participation, but doctors in the consult room are not. BMJ Innovations 3 (2): 65–70. https://doi.org/10.1136/bmjinnov-2016-000134

Russ, Hayley, Shmuel M. Giveon, Granek Catarivas and John Yaphe (2011) The effect of the internet on the patient–doctor relationship from the patient’s perspective: A survey from primary care. IMAJ-Israel Medical Association Journal 13 (4): 220–224.

Sanders, Remco and Annemiek J Linn (2018) A mixed method study investigating the impact of talking about patients’ internet use on patient-reported outcomes. Journal of Health Communication 23 (9): 815–823. https://doi.org/10.1080/10810730.2018.1514443

Sarangi, Srikant and Celia Roberts (eds) (1999) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings. Berlin: De Gruyter Mouton. https://doi.org/10.1515/9783110208375

Schrader, David C. and James Price Dillard (1998) Goal structures and interpersonal influence. Communication Studies 49 (4): 276–293. https://doi.org/10.1080/10510979809368538

Schrank, Beate, Ingrid Sibitz, Annemarie Unger and Michaela Amering (2010) How patients with schizophrenia use the internet: Qualitative study. Journal of Medical Internet Research 12 (5): Art. e70. https://doi.org/10.2196/jmir.1550

Seeman, Amanda (2013) Disruption of ritual: Doctor/patient interactions in the era of internet. Unpublished doctoral dissertation, University of New Mexico.

Silver, Michelle P. (2015) Patient perspectives on online health information and communication with doctors: A qualitative study of patients 50 years old and over. Journal of Medical Internet Research 17 (1): Art. e19. https://doi.org/10.2196/jmir.3588

Smith, Dorothy E. (1978) ‘K is mentally ill’: The anatomy of a factual account. Sociology 12 (1): 23–53. https://doi.org/10.1177/003803857801200103

Sommerhalder, Kathrin, Andrea Abraham, Maria Caiata Zufferey, Jürgen Barth and Thomas Abel (2009) Internet information and medical consultations: Experiences from patients’ and physicians’ perspectives. Patient Education and Counseling 77 (2): 266–271. https://doi.org/10.1016/j.pec.2009.03.028

Stevenson, Fiona A., Cicely Kerr, Elizabeth Murray and Irwin Nazareth (2007) Information from the internet and the doctor-patient relationship: The patient perspective – A qualitative study. BMC Family Practice 8: Art. 47. https://doi.org/10.1186/1471-2296-8-47

Tan, Sharon Swee-Lin and Nadee Goonawardene (2017) Internet health information seeking and the patient-physician relationship: A systematic review. Journal of Medical Internet Research 19 (1): Art. e9. https://doi.org/10.2196/jmir.5729

Woodward-Kron, Robyn, Melanie Connor, Peter J. Schulz and Kristine Elliott (2014) Educating the patient for health care communication in the age of the world wide web: A qualitative study. Academic Medicine 89 (2): 318–325. https://doi.org/10.1097/ACM.0000000000000101

Xie, Bin, David M. Bilts and Mikhael Shor (2006) The physician–patient relationship: The impact of patient-obtained medical information. Health Economics 15 (8): 813–834. https://doi.org/10.1002/hec.1098



How to Cite

Roper, L., & Sturman, N. (2021). ‘We all have friends like that’: How Australian patients avoid Dr Google shame. Communication and Medicine, 16(3), 267–279. https://doi.org/10.1558/cam.39254