Is Google responsible for the decline of cognitive medicine?

Apparently, thinking and information aren’t highly valued by the Google-raised patient:

There is so little respect for the mind these days, and medical education in general. When you can Google your health and play doctor in your mind, that some how extrapolates to a dumbing down of the cognitive physician.
It’s almost as if the patient believes that since they “know” what’s going on, or they can “figure it out” on line, that somehow their primary care doc is just as simple minded. They seem to foolishly believe that 7 years of post graduate training is not as simple as playing Google MD.

Comments

KipEsquire
“They seem to foolishly believe that 7 years of post graduate training is not as simple as playing Google MD.”
That’s Scenario #1; here’s Scenario #2:
Internist meets with healthy 39yo patient after a resting ECG as part of a routine biannual physical.
“You have a blip on your ECG that is very common and almost certainly nothing, but I want you to take a stress test and echocardiogram.”
“What is it?”
“Just a blip. It usually vanishes in the stress test, which means it’s nothing.”
“No, I mean what is it? Write it down so I can Google it when I get home.”
I respectfully submit that the physician is the obnoxious one here, not the patieint.
We may not have “7 years of post graduate training,” but some of us do have a vocabulary that is more expansive than “blip” and “nothing.”
Anonymous
Yes, but with your example if you tell them what the technical term for it is then when they google it they will be inudated with textbook articles and sources claiming sudden death. Yes, this may lead to sudden death, but your doctor knows that this is not the case for the vast majority. But now you have a patient who thinks he is being lied to and thinks he is going to die at any minute because he googled a the term “ST depression.”
I have a chronic disease and when I was diagnosed I googled it. What I saw made me cry. I thought I was heading for a painful state of existence in a wheelchair. You have to watch out or you will start believing that diseases read textbooks when in fact they don’t.
Anonymous
Googled “leg pain” and made the statin connection long before my primary care doctor recognized the connection. You guys are good, but you’re not perfect.
Anonymous
Can’t wait for the public to start Googling how to do their own appendectomies.
Gasman
Let the patients google away. The bright ones will assimilate a lot of information yet recognize that a collection of facts are not knowlege, and an experience of one patient does not constitute wisdom. They will seek a physician who can act as a mentor and consultant to them using those 7+ years of training and subsequent experience from other patients to avoid having to repeat for themselves all of the intern level mistakes that come from having no experience.
Other patients will google, realize they are in posession at that moment of a few facts their doc has not, and attempt to treat themselves, using the docs as a set of tools they can choose from to get the treatment they have chosen for themself.
Anonymous
You can change your own oil or have someone do it for you. you can cut your own hair if you like. You can knowingly kill yourself with cigarettes or alcohol. Should statins and basic antibiotics be available OTC? Should the pharmacy have basic diagnostics you do yourself to screen for CK and LFT elevation on your self-administered statin? If you can google it like Anon 1:08 maybe the answer is yes. This is the way things are in other countries that some people seem to think have a better idea.
Anonymous
After diagnosing myself with horrible diseases several times, and being wrong every single time, I now fight the urge to diagnose myself really hard. It is irresistable so I do it anyway.
Then I go see one of my fellow docs, tell them what I think that I have, and then tell them that if I am right, it would be the first time, so please ignore my opinion.
Those who diagnose themselves from google, and think they don’t need a physician are fools. People want “full information”. They also want to feel good about going to their doctor. Those two things are incompatible. For example, I don’t want anyone to say the word “cancer” to me unless they are scheduling the actual biopsy to rule it out, or I resist their workup needed to evaluate the need for that. Otherwise I prefer “I’d just like to check that out a bit more.”
TMI = too much information = totally miserable interlude
And then there has been all the teaching for generations that one communicates to patients more effectively using non-clinical language.
Anonymous
I find it ironic that this post is juxtaposed with one about non-emergencies at the ER.
I guess the public is supposed to be smart enough to know ahead of time that their chest pain is nothing serious, but too dumb to be trusted with Google.
Surely there is a happy medium here somewhere?
Dr. Matthew Mintz
In my experience, even patients who google information still want the opinion of a medical professional. Anyone can look stuff up, but it takes years of training and experience to find high quality information and interpret this in a meaningful way for patients to make informed decisions. I started my own blog in an attempt to help patients (mine and other’s) make sense of some of what’s out there. The problem is that though patients value a physician’s cognitive services, they and insurers don’t seem too willing to pay for this.
Anonymous
Yet another reason to go into a field heavy in procedures. No one is going to Google their Broken Ankle back together.
Chris, Pharm.D.
We have the same problem in the field of pharmacy as well. People can access the Full Prescribing Information for a particular drug they have been prescribed, then read the dozens of side effects listed for the drug. Or they see a drug-drug interaction listed that is really insignificant. Then they decide not to take the drug.
I had it happen this weekend when an ICU patient with a blood glucose in the 400s refused her insulin because she was taking Byetta at home and had read that “the insulin will kill me if I get it. I’ve been on Byetta.”
Anonymous
Anon 9:27pm
“No one is going to Google their Broken Ankle back together.”
true, but now they’re going to tell you how many, what kind and how long – the pins should stay in for.
Anonymous
No offense intended, but I’ve been reading this blog long enough to see numerous posts in favor of billing patients for every e-mail and phone call, as well as supporting the current practice of 5-minute consults as an economic necessity.
Doesn’t seem reasonable, then, to berate patients for seeking whatever information they can get elsewhere. Two sides to every issue, you know.
Don’t personally see why the internet can’t be used productively by physicians as a means of helping patients define and refine their questions prior to appointments. Just help them understand what constitutes a credible site.

Is Google responsible for the decline of cognitive medicine?

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