The advent of the internet, combined with social media, has made everyone experts and has increased the disdain for authority.
No where is that more apparent than the firestorm that surrounds vaccines and its detractors.
The Los Angeles Times’ James Rainey writes a column on the phenomenon, observing the backlash against a well-written, nuanced piece debunking the link between vaccines and autism.
But as we know, those who already believe there is a connection are unlikely to be swayed. And on the web, it’s easy to find data and studies that fits an already established mindset.
Mr. Rainey notes a danger to this growing phenomenon:
Citizens armed with information are sure they know better. Readers who brush up against expertise believe they have become experts. The common man rebels against the notion that anyone — not professionals, not the government and certainly not the media — speaks with special authority.
Where it stops, nobody knows. But already we see a wave of amateurs convinced they can write a pithier movie review, arrange a catchier song, even assess our planet’s shifting weather conditions, better than the professionals trained to do the job.
Of course, we are seeing this in medicine as well. 60+ percent of patients consult the internet for health information, and a small but growing minority feel they can act on what they find on the web without physician guidance.
To be sure, doctors and other health professionals don’t get everything right. But anyone can find information on the web, which can be of dubious accuracy.
Knowing what to do with that data can only come with experience and training.
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{ 6 comments }
As a medical librarian who provides consumer health/patient education materials to clinicians and to patients who visit our library, I congratulate you for airing this issue. The fact is, there is good quality, reliable information on the Internet as well as the spurious data to which your blog entry refers.
Some patients/consumers are just plain unaware of how to determine the reliability of health (or any other) information on the Internet, and some don’t care…they just want data to fit their reality.
For those who would like a good explanation, here’s a link to “Healthy Web Surfing” from the National Library of Medicine:
http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html
As fewer talented young people pursue careers in medicine, look for the use of internet personal diagnostics to skyrocket. Change!
Good morning and thanks for citing (I think) Pew Research Center survey data regarding the percentage of American adults who look online for health information (see: The Social Life of Health Information, http://bit.ly/dhIrC).
However, “disdain for authority” is not something we have found in our surveys.
In fact, one of our key findings is that most people use online health resources to supplement advice they get from doctors and other health professionals. After 10 years of researching this field, we have no evidence that the internet is replacing traditional sources of medical advice. Yes, many people are gathering and sharing health information online, but they are also discussing it with friends, family, and health professionals.
If anyone is interested in more information on this, please see:
Pew Internet: Health
E-patients.net
Or contact me directly: sfox at pewinternet dot org
Though it is fair to say that more people are accessing the internet for medical information and increasing their level of expertise in the process, in my mind the disdain among many for their physicians and the current medical system preceded their ability to access all the information online. The information presented on the internet has simply allowed those with a dogmatic approach to health to further justify unsubstantiated beliefs.
Whether it be distrust of the medical system, use of alternative medicines, theories on the causes of illness or beliefs in the “curative” powers of specific practices, there have always been those who chose not to benefit from modern medicine. As is the case for many forms of extremism, the internet simply provides a platform for their voices to be heard by many. In some cases they may convert others, but in many other cases, they are simply finding those who have a similar belief system.
On the other hand, for those who recognize their doctor as an educated partner and realize that the information on the internet may not be entirely factual, this access to information allows patients to be more active in management of their health and to ask intelligent questions. This is a good thing.
I’m a doctor. I’m a GP (family doctor) in Wales, UK and I teach medical students. I work in a deprived area and I wish that many more of my patients, rather than less, accessed information that could help them be more health. But many of my patients do not have easy access to the internet. This impacts on their health in many ways. One that is less often considered is that digital exclusion leads to reduced income (http://news.bbc.co.uk/1/hi/technology/8302598.stm).
Reecently there was a post on StoryTellERdoc about “Grim Google”. This related the story of a young, healthy man who presented in ER with bright, red rectal bleeding convinced he had bowel carcinoma because he had googled his symptoms and saw that this was a possibility. The story itself and most of the comments are quite scathing. But is this the appropriate response to this story?
In the UK we know that despite universal access to healthcare we still have differences in survival rates between areas, with patients in well-off areas living longer (http://news.bbc.co.uk/1/hi/health/8387703.stm). This may partly be due to delay in diagnosis.
With regards to late-stage diagnosis of colorectal cancer, research in 1996 in the US (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380736/)showed that patients living in areas of low socio-economic status (SES) were significantly more likely to be diagnosed at a late stage compared to those living in areas of high SES. You may think that times have changed, but more recent research in Denmark- covering 1996-2004- shows that older, wealthier patients, and younger more highly educated patients are less likely to be diagnosed with rectal cancer at a late stage.
So a simple story that seems to illustrate the fallacy of patients trying to diagnose themselves online, may instead represent the awareness and health behaviours which mean that those with the know-how feel empowered to seek care for what could be life-threatening symptoms.
We should be encouraging more of our patients to access health information, especially those who will find access harder. In fact we should be advocating against digital exclusion because its influence as a cause of health inequalities may increase in coming years.
This is one reason that I now prefer when patients address me as “dr.” instead of my first name. That’s what I am, and that’s what my training offers them.
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