General practitioners’ challenges and strategies in dealing with Internet-related health anxieties—results of a qualitative study among primary care physicians in Germany

Abstract

Summary Time and again, it is discussed that in medical practices, the number of patients who develop health anxieties due to extensive health information searches on the Internet is increasing. The objective of this study is to explore and describe general practitioners’ experiences and attitudes towards cyberchondria patients as well as strategies to stabilize affected patients. Following a qualitative approach, oral personal semi-standardized interviews with general practitioners (N = 38) in Rhineland-Palatinate, Germany, were conducted in 2019. In the course of a content analysis, one can see that most interviewees see the emergence of Internet-related health anxieties as an increasing problem in everyday care. Affected patients not only show marked levels of doubt and nervousness as well as hypersensitivity to their own state of health, but also low confidence in the physician. In addition to compliance-related difficulties, the high need for advice and the demand for further diagnostics are regarded as major problems. Various approaches were identified by which general practitioners respond to unsettled patients (more consultation time, recommendation of reputable websites, information double-checking, expanded history questionnaire, additional psychosocial training).

Online enquiries and health concerns – a survey of German general practitioners regarding experiences and strategies in patient care

“…However, three quarters of GPs observe as an increasing problem the fact that some of their patients acquire health concerns as a result of extensive online consultations. In the observation of the respondents, this trend increased in the course of the COVID-19 pandemic; this is reflected in the assumptions of relevant reviews (Wangler and Jansky 2020;Link et al 2022;Starcevic et al 2021).…”

“…This took into account the patient and doctor surveys mentioned. On the other hand, the results were fed into a qualitative preliminary study (Wangler and Jansky 2020), in the course of which 38 GPs in Rhineland-Palatinate were interviewed on the subject of cyberchondria. The results were decisive, in particular to firm up and concentrate the questionnaire, and they served specifically to generate two item sets (questions 7, 10).…”

“…If internet-related health concerns are too advanced and the GP is no longer able to stabilise such patients, it will be important to have an adequate range of low-threshold, psychosocial services to which doctors can easily and quickly make referrals. In view of the lack of available capacity in psychotherapy provision, compact online treatment could offer a valuable service, especially for patients affected by cyberchondria (Te Poel et al 2016;Wangler and Jansky 2020;Tyrer 2018).…”

“…Because of their role as primary caregivers, GPs are especially affected by internet-related health concerns of patients. A qualitative study in 2020 provided evidence that GPs see the cyberchondria phenomenon as a growing challenge in everyday practice (Wangler and Jansky 2020). The problems raised include not only a considerable level of doubt and nervousness as well as hypersensitivity with respect to one's own state of health, but at the same time also a low level of confidence in the doctor.…”

Diagnostic Performance of an App-Based Symptom Checker in Mental Disorders: Comparative Study in Psychotherapy Outpatients

“…In addition, digital health information may lead to increased illness anxiety [ 20 ], which in turn increases unnecessary health care use and costs [ 21 , 22 ]. In this regard, health professionals are also facing new challenges (eg, biased expectations and less trust in medical advice) with internet-informed patients [ 23 ].…”