Given the confusing world of the internet, doctors are often left to contend with inaccurate or incomplete information brought to them by their patients. A team of Virginia researchers set out to clarify what kind of information patients are accessing and how doctors can proceed.
Most Patients Bypass Hospital Websites for Ortho Information

“Patient Perceptions and Current Trends in Internet Use by Orthopedic Outpatients,” can be found in the October 2017 edition of The HSS Journal.
Co-author Brian Werner, M.D. is an orthopedic surgeon at the University of Virginia Health System in Charlottesville. He told OTW, “The internet has become pervasive throughout medicine, and more frequently patients have read about their physicians, their condition, and potential treatments before ever arriving in a physician’s office. This is particularly true for orthopedic surgery, but there is limited data investigating what type of information patients are obtaining and how complete or accurate that information is. With this study, we sought to investigate a baseline for our large, diverse patient population that presents to our outpatient clinics of our tertiary referral center.”
The authors wrote, “One thousand two hundred ninety-six questionnaires were distributed to consecutive patients at orthopedic outpatient clinics which consisted of questions pertaining to patients’ internet use. Basic demographic data were collected, and subgroup analyses were performed to examine the effect of three variables (age, gender, and clinic type) on various outcomes.”
Dr. Werner commented to OTW, “The vast majority (about two-thirds) of patients access the internet for orthopedic information, however, only one-third of patients seek information from institutional websites. The majority of information is obtained from other sources, where quality control may not be as strict. Younger patients used the internet more frequently for information and found it more useful.”
“It is important to recognize that the majority of patients will have researched their condition, possible treatments, and likely their surgeon prior to a visit to an outpatient orthopedic clinic. It is important to address what patients have already researched during a clinic visit and correct any inaccurate information. It is also important to make patients aware of accurate, vetted information on institutional websites which are available.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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