Must we appear to be all-knowing?: patients' and family physicians' perspectives on information seeking during consultations.

OBJECTIVE: To compare patients' opinions about family physicians looking up medical information during consultations with family physicians' expectations of how patients would respond to their using sources to find answers to medical questions. DESIGN: Survey. SETTING: North York, Ont. PARTICIPANTS: One hundred fifty-three family practice patients, 54 family physicians, and 21 family practice residents. MAIN OUTCOME MEASURES: Patients' self-reported confidence in their family physicians and their perceptions of the quality of care after seeing physicians look up medical information, both without specifying the physician's source of information and with reference to several specific information media. Family physicians' predictions for how patients would respond to their using resources to answer medical questions. RESULTS: When the information source used by physicians was not specified, 9% and 7% of patients reported decreased confidence and perceived lower quality of care, respectively. When the information source used by physicians was specified, the proportions of negative responses for patients' confidence and their perceptions of quality of care were 39% and 31%, respectively, for Internet search engines (ISEs); 8% and 7% for online resources designed for physicians (ORDP); 27% and 27% for personal digital assistants (PDAs); and 10% and 9% for hard-copy medical textbooks (HMTs). When the information source was not specified, 32% and 12% of physicians expected patients to report negative responses for confidence and perceptions of quality of care, respectively. When the information source was specified, 51% and 33% of physicians expected patients to report negative responses for confidence and perceptions of quality of care, respectively, for their use of ISEs; 16% and 8% for ORDP; 20% and 12% for PDAs; and 36% and 21% for HMTs. Younger patients were more likely to respond negatively to physicians' use of resources, especially if the source was an ISE (P<.001). Physicians earlier in their careers were more likely to expect negative patient responses (P<.05). CONCLUSION: Family physicians overestimated the decrease in patients' confidence caused by seeing them look up medical questions. While most patients responded positively, a substantial proportion of younger patients reported decreased confidence. Patients believed the best sources of information were ORDP and HMTs.