The trouble with Dr. Google

Things have been a bit tough of late, the bad economy is starting to bite, and you’re feeling the pressure.  To top it all, your body has been acting strangely in ways it never has before.  Your muscles twitch in funny areas for hours at a time, you tire easily, and you have fleeting pins and needles in your limbs.  Over the weeks these symptoms have become worse. The last straw comes when you notice it is getting harder to swallow your food without thinking about it.

You do what any overworked but doctor-shy person does in a free moment – you consult Dr. Google.  He takes your request in a fraction of a second. You learn the muscle twitches are called fasciculations.  You enter “muscle fasciculations, muscle fatigue and swallowing difficulty” into the Search window.

And Dr. Google offers suggestions straight away.  Every site on the long list brings confirmation.  Some of them know exactly how you feel, and what your symptoms are.  You have motor neuron disease at least, or perhaps, if you are lucky, multiple sclerosis.  While the latter conjures up visions of being wheelchair bound at your kids’ weddings in a decade or so, eating your wedding cake by a tube, the former strikes terror into your heart.  You read the median survival rate for motor neuron disease is between three and five years.  Death comes by drowning in your own spit.  Some people live longer.  You read that Steven Hawking is one of the “lucky” ones.  He has a brain to entertain himself, a job where he thinks all day, and all sorts of fancy machines to talk and stay alive.  You have two young kids, a job that needs you to be healthy, a family, a spouse.

The diagnosis knocks you off your feet.  Every day that passes your symptoms increase.  Your appointment with a neurologist, pushed ahead of the normal waiting time by a worried family doctor, is still three weeks away.  You cannot get to sleep at night.  When you do, you wake in the early hours, sometimes due to the twitching of muscles in your legs, or in your face, or in your groin.  You were stressed before the diagnosis, now your anxiety goes through the roof.

Your kids pick up that something is wrong, but there is a conspiracy of silence at home.  No one else must know.  The possibilities are not to be discussed until the diagnosis is confirmed.  You begin to wish multiple sclerosis upon yourself rather than motor neuron disease. For three long weeks a sense of impending doom hangs over your household.

When the long dreaded but highly anticipated neurologist’s appointment finally arrives, the result is a dramatic shock.  You are incredulous, disbelieving. “Anxiety?”

“That’s all?” you ask in shock.  “But I feel so terrible!”  Exactly.  Anxiety does that to people.  A wave of profound relief and feeling foolish washes over you.  It takes a long time to convince yourself that your real, live, speaking, laughing neurologist is correct.

How could Dr. Google be so wrong?

For a start, Dr. Google does not know anything about you.  He has not asked you any questions.  You asked him, “What could cause such and such?”  And he provided an answer.  But this was not information tailored to your history, environment, and the socioeconomic and external pressures on you.  The fine nuances of your symptoms, dissected and probed by your real neurologist suggested the most likely diagnosis during the history.  Dr. Google did not even examine you.

Dr. Google does on occasion suggest correct diagnoses when asked the right questions — social media is full of these stories.  But the stories like yours do not really reach the media, and so there is no real way of knowing how often Dr. Google’s diagnoses are as wrong and as potentially damaging as yours was.

What should you do?  For a start, from now on put your trust into real live doctors where you can as an initial step, with Dr. Google as a reference after a diagnosis if you need one.

Could you sue Dr. Google, as you would a live doctor, for wrong diagnosis, pain and suffering?

Good luck with that.  Dr Google’s work address, to which you must have the court papers delivered, is not listed anywhere.

Even on Google.

Martin Young is an otolaryngologist and founder and CEO of ConsentCare.

Submit a guest post and be heard on social media’s leading physician voice.

email

Comments are moderated before they are published. Please read the comment policy.

  • http://twitter.com/FairCareMD Alex Fair

    Solely self-directed care is about as wise as self-directed investing.  You could have a gift for it, but it can be dangerous.  Unlike investing though, you know your symptoms far better than any amateur or analyst ever knows a company, but the devil is in the differential diagnoses here.

    Patient self-education is beneficial and here to stay.  The critical factor is now for the Physicians and allied healthcare professionals to adapt to the educated patient, taking their more informed, if unguided, questions and working people through the likely diagnoses.  Meeting us in the middle as partners in our care is the best path. Together, we can drive much better outcomes.

    This is why our Google friendly site ultimately educates AND connects patients to doctors because one without the other is just gambling …and do you really feel lucky?

    • http://twitter.com/MartinYoung Martin Young

      Absolutely.  Google, or perhaps more fairly the abundance of undirected medical information, can still do damage.  This is my point.

      • Sheila Cummings

        I am a legal nurse consultant by trade and have worked with all sorts of physicians in my 32 years as a registered nurse.  There have been many instances where I found myself “interpreting” what the physician just said so that the patient left with a good understanding, not only of their disease process, but just what the physician needed them to do to get better.  Judging from this thought provoking and eloquently written article by the good doctor, my sense is that you are one of the physicians who spends time discussing conditions with patients and have that good rapport necessary for healing to occur.  My sense is from some of the comments that Google often times is the port in the storm when physicians cannot or do not supply the information that is so desperately needed in times of illness and fear.  I only hope these are a minority of cases.

        • http://twitter.com/MartinYoung Martin Young

          Thank you, Sheila.

          I try to do as you say, as do many of my colleagues.  But there are enormous economic pressures on doctors, with time spent with patients suffering as a result.  No one really benefits in the long term.

          The contrasting topics on this blog are very revealing – “Bill your doctor for making you wait” and then “The secret to better patient care is time.”  Each writer makes valid points.  But how to get the two together in a happy and effective medium is the critical challenge.

  • Rebekahroxanna henderson

    Well, it took months and months to get a physician to agree that there was something wrong with me. Ovarian cancer. Dr. Google won on that one.

    • http://twitter.com/MartinYoung Martin Young

      I’m not suggesting some people do not derive benefit, or diagnose themselves successfully.  I wonder what the accuracy as a percentage of all those using Google for self diagnosis is.  My suspicion is that it is relatively low.

  • http://www.howtobesick.com Toni Bernhard

    Dr. Google is such a mixed blessing. I’m writing an article on it right now — it expands on themes in my book, “How to Be Sick.” What I’ve found is that for any given medication, you can find someone for whom it was the cure-all and you can find someone whose health took a tailspin after starting it. You have to realize that you’re going to get this huge range of reactions if you’re going to use Google in this way. 
    On the other hand, if, like me, you suffer from a little understood illness, you can use Google to keep abreast of the latest research and treatment possibilities that you can then take to your doctor. I have one nagging condition (not related to my illness) for which I found the proper medication through Google and brought it to my doctor who prescribed it because his own subsequent research showed it to be the best one for the condition. 

  • Anonymous

    Of course, of all the diagnoses you could have chosen to illustrate your point, you had to pick anxiety.  As someone with an anxiety disorder, I can tell you that at least Dr. Google doesn’t see that as the answer to everything. Far too many doctors hear the word “anxiety,” and then they are done with the diagnosis. Dr. Google gave me options when Dr. Real Life just said, “Here, take these antidepressants.” And Dr. Google was right on the money with premature ovarian failure (not “Anxiety’s stressing you out so much that your periods have stopped”), a tonsillotlith that became large enough to require surgery to remove completely (not “Anxiety just makes you feel as if you have something stuck in your throat”), and pneumonia (not “Anxiety is just aggravating your asthma symptoms–all you have is a chest cold”).

    Thankfully I have a great doctor now who listens to me. I’ve lived with anxiety long enough to know when it’s flaring and when something is clearly not right otherwise. But if it weren’t for Dr. Google, I wouldn’t be informed enough to have those conversations with my doctor.

    • http://twitter.com/MartinYoung Martin Young

      But who of the two is more important to you, and more effective in helping you through this?  The trouble with anxiety is that the symptoms can mimic hundreds of different diseases in all systems of the body.  So it is a great example to use.

      I estimate 9 out of 10 people who tell me they have googled their symptoms or disease have a distorted perspective in some way.  Especially if the cause is as yet undiagnosed.

      • http://www.twitter.com/alicearobertson Alice Robertson

        You must attract psychic types?:). Any doctor who is really informed can patiently work through google information….particularly a specialist in one area of the body. Although, I admit at first it would add to your workload…but eventually make you a better doctor….it’s a work related challenge.

        I think your real challenge is other doctors who get burned out with the daily grind….they do not serve their patients well..leave you with some bad PR….a type of legacy not easy to overcome…if doctors were more accommodating, open minded…willing to be challenged the patients would not feel so lost. Once we found a great doctor…who encouraged email….even sharing that I must know I can contact him anytime….I quit searching online…I had a research doctor who could answer anything honestly…but what I admired was his ability to say, “I don’t know…”. By the way… he was an ENT who encouraged online use. And he tried to answer every question…would offer to stay after and clear his desk and chat with me….gosh I miss him…a comforter to my broken mother’s heart.

        • http://twitter.com/MartinYoung Martin Young

          I agree with you, Alice.  If you read my earlier posts on KevinMD you will see that I support ePatients and consider myself an eDoctor.

          But I see the damage that medical information on the web can cause, with experience of this many times over. Most patients’ experience, either positive or negative, is limited to one case – their own.  

          If there was data out there that critically analyzed the positive and negative that much medical information on the web can do, and this was handled in the same way that a new drug was, I doubt that Google would pass FDA approval!

          • http://www.twitter.com/alicearobertson Alice Robertson

            I can understand the position you are in….if
            I were a doctor I would get flustered and feel as though I need to wade through sewage via the Internet postings…management….government regulations,etc. But if Google is made more viable it hurts free speech…that could have a precedent on my free speech to share about cures I have read about elsewhere online…or in my travels. In truth, I think patients feel that doctors are closed minded and they become desperate….maybe even too desperate or over zealous.

            Can I ask if you are able to quell their fears?

          • http://twitter.com/MartinYoung Martin Young

            With enough time and resources we could do almost anything, even make 95% of our patients happy 95% of the time.  But doctors are pressured on all sides, unlike the internet!  So, is medicine in a good situation?

            According to the majority of opinions on this site from both doctors and patients, clearly not!  So I have as many fears as my patients do, just different ones.

            Maybe I’ll keep that for my next blog post!!

      • Anonymous

        Why do I have to choose? That’s a false dichotomy. The two now work together effectively. Before, when I knew something was wrong but had no evidence, I suffered terribly, which in turn did in fact exacerbate my anxiety. But just because someone is anxious doesn’t mean something else isn’t wrong. Far too many doctors will use anxiety, depression, overweight/obesity, or menopause to explain away everything for women.  Dr. Google gives people other legitimate options. I’m sorry to hear you think 90% of your patients don’t know how to use the Internet to find quality information about medicine. That may or may not be true, but if it is, it presents an excellent opportunity for you to educate them in critical thinking.

    • http://twitter.com/MartinYoung Martin Young

      Just to be clear, I wrote this for a person very close to me.  This is exactly how it happened – a real example. I did not need to make it up.

  • Anonymous

    I never even considered Dr. Google when I first started having arrhythmia problems.  Perhaps if I had, it wouldn’t have taken 10 years for a recently-minted PCP and a dismissive cardiologist to come up with the correct diagnosis (classic A-Fib symptoms had been attributed repeatedly to anxiety, allergies, and exercise-induced asthma).

  • Anonymous

    I never even considered Dr. Google when I first started having
    arrhythmia problems.  Perhaps if I had, it wouldn’t have taken 10 years
    for a recently-minted PCP and a dismissive cardiologist to come up with
    the correct diagnosis (classic A-Fib symptoms had been attributed repeatedly to anxiety, allergies, and exercise-induced asthma).

  • http://www.twitter.com/alicearobertson Alice Robertson

    What should you do?  For a start, from now on put your trust into
    real live doctors where you can as an initial step, with Dr. Google as a
    reference after a diagnosis if you need one.
    Could you sue Dr. Google, as you would a live doctor, for wrong diagnosis, pain and suffering?>>>>>

    Say what?  Trust a real live doctor?  Are you being facetious?  Ha!  I am…but not completely…I deal with the Cleveland Clinic…oh…I should feel so safe…right?  The mistakes….the problems (I real live doctor didn’t read the lab notes and cancer spread in my precious daughter’s lymphs)…put my trust in an infallible, very well-educated doctor?  I agree we need to have some trust in a doctor, but real trust in a worthy doctor who has all the goods is rare….trying to find a brilliant, empathetic, highly skilled doctor is not easy….until then let’s enjoy the First Amendment rights of posters online….but learn how to discern….

    Didn’t Google just lose a $500 million suit with…um…the Justice Dept. for running ads that helped patients save money on scripts?   I fear this stuff more than I do bad counsel online.

    • http://twitter.com/MartinYoung Martin Young

      Sorry to hear about your daughter.  But medicine is not an exact science.  If it was, it would be easy. And there would be far fewer mistakes, no, potentially NO mistakes whatsoever.  The problem is that medical information on Google is not vetted.  So discernment, as you point out, is critical. But how does the lay person know where to put their faith? Not in a website as a primary source of care, that is for sure.

      Again, I would love to have statistics as to whether Dr Google does more good or more harm, but unfortunately I can’t find them.  Even on Google

      • http://www.twitter.com/alicearobertson Alice Robertson

        LOL  Yeah….even Google has limitations…yet, how would that type of information be found?  Patients would say it’s helpful, and overall I think many doctors would like it to go away.  As limited as Google is…..unfortunately, so are humans.

        So…..is it the information or the receiver…both?  And if a patient goes against medical counsel and goes with controversial treatments when does the doctor step aside?  Who is really in charge?  Science can be just as relative as opinions….and sometimes they are the same thing.

  • Leslie White

    Dr. Google and I have a better track record than my very good doctors on multiple chronic diseases. Educated patients have brains enough to skip non vetted web sites.

    Why do doctors think they are smarter than EVERYONE? It’s offensive.

    • http://www.facebook.com/brianpcurry Brian Curry

      Smarter? Probably many do, but certainly not all of them.

      But better educated? You bet. Might have something to do with the years they have spent learning and training to become physicians. Mind you, doesn’t make one infallible, but surely you can see why a doctor might feel he or she knows a thing or two.

      • Leslie White

        Perhaps I should have said that many doctors are dismissive of of those without a formal medical education. There are many other paths to education that help form others with the ability to analyze and think. Doctors don’t have exclusive rights to those traits. 

        I’m not slamming doctors on the whole. I have absolutely wonderful, smart, caring physicians who help me live a normal life and they mean a great deal to me. But their education doesn’t negate my knowledge of my own body and ability to recognize patterns with my own medical conditions. They are also not threatened by my occasional participation in my health care. It is my life, after all. 

        My problem is that this story paints a representative story of patient research that leans towards unfair.

        Also, I would like to say that I find this site endlessly fascinating. The variety of the doctors’ points of view is quite striking.

  • Daniel Wann

    This article really hits home with me. I had the exact same symptoms as Dr. Young describes in this article, and spent a great deal of time and energy thinking I had a neurological disease of some sort. This of course led to worsening symptoms, which increased my anxiety even more. Unfortunately I didn’t have insurance and couldn’t afford to go see a neurologist, so I decided to just wait it out. I realized that I was probably being a hypochondriac, and that simple thought made the symptoms markedly improve.

    I haven’t had any more problems with it in quite a while, and have resolved myself to stay far away from Dr. Google.

    • http://www.twitter.com/alicearobertson Alice Robertson

      Before the Internet controlled our minds people bought books…or used the library with scanned microfilms…or drove to medical libraries. Google just makes it easier…louder even. The only real cure would be illiterate patients:)

  • http://twitter.com/whatscorrect don peterson

    Much is written on this site about trust and what respect we lay-people should have for doctors and for their profession.  I respect doctors like I respect everyone else, no more, no less.  You do your job and I’ll do mine.  When you fail at your job I’ll chalk that up to you’re just human, like me. But I will ALWAYS choose to be an informed consumer even if you doctors think otherwise.  Here’s why:

    My wife and I put our trust in the doctors we took our daughter to and hoped for the best, but don’t believe we got their best.
    Our daughter (let’s call her Amy) suffered from constant cycling between constipation and diarrhea. She was often nauseous and dizzy (she called it “car-sick”) and would vomit occasionally.  She began having headaches that would linger for hours.  She had a series of rashes and bouts of acne that seemed to come and go.  

    Of course, at 18 she was tossed out of her pediatric practice so we took her to our family physician.  That doctor thought she might have some sort of staph infection and prescribed an antibiotic, which she took to no avail. This past April she had a severe enough anaphylactic reaction to what she thought was peanut (we had known since early childhood that she had an acute peanut allergy) that she went to her college’s student health office where they told her to inject herself with her epi pen. They called an ambulance and sent her to the hospital where 3 different physicians observed her while the symptoms abated. Then they sent her back to her dorm.  Later came a bill for $5K.

    When she came home from school this summer we noticed her arms and legs were full of bruised spots.  She told us that she had scratched them raw and that the itching seemed deep under her skin, thus the bruising. We took her back to our family physician.  That doctor’s nurse practitioner said to Amy, “Well, if this is anything more than eczema I don’t know what it is.” So we took her to a dermatologist.  He prescribed a cream that cost $400.  We asked the pharmacist what what was in this cream that made it so expensive.  She said it was the latest combination cream, vitamin A and something else. She suggested she could call the derm and ask if Amy could have the two separate creams of the same drugs since both would cost less than $15.  After all of that, it didn’t solve the problem.

    Reading online that food allergies and certain food intolerance can cause the symptoms Amy had I asked her derm to order a blood serum IgG and IgE test so that we could determine if she was reactive to foods other than peanut.  When the test results came back from the lab the derm never called.  Finally, we called and asked them to send us the results.  When the results arrived we went online to the test maker’s website to translate the results. We found with dismay that not only was she super-sensitive to peanuts, but was also sensitive to casein, gluten, eggs, black pepper and pineapple.  We went shopping.  We bought all of the things Amy needed to be casein, gluten and dairy free.  Amy shifted her diet to exclude the things that the test said she was sensitive to and now, after just 3 weeks, she is back to normal lower GI function, her itchy spots are gone and she is no longer nauseous or has headaches.  She feels so much better she, and we, cannot believe it. 

    We’ve still never heard from her derm.  I suppose we should take her to an allergist now so he can confirm what we already know.

    I thank God for the Internet and for informative websites. 

    • http://twitter.com/MartinYoung Martin Young

      I googled all the symptoms you speak about.If you look further on the internet you will probably find that heavy metal poisoning has similar symptoms and signs as your daughter had.  Did you test her for that?  Hair testing is available, and widely marketed on websites picked up by Google.  But it is also inaccurate, and generally discredited as being a useful test by the scientific establishment.  As are IgG allergy tests, by the way.  Lots about that on Google too.For the record, pregnancy and STD’s came up as well in my search.

      But the peanut allergy is a dead give away in my opinion – one severe allergy suggests possibility of another.  So perhaps she should have seen an immunologist before embarking on diets that exclude everything else you mentioned, because of a test that is regarded as useless by immunologists.  Shopping must be a nightmare for you all.

      Anxiety, according to Google, and from highly reputable websites can do the same.  

      Good luck – I hope things work out well for you! :)

      • http://twitter.com/whatscorrect don peterson

        Thanks for your thoughtfully sarcastic retort.  What we did was what we were left to do by physicians who did nothing at all…I didn’t claim that our search was accurate on all levels or by any means complete.  It was simply the best we could do with little or no support from the doctors we took our daughter to see.  An intelligent individual is perfectly capable of determining the pedigree and providence of what he or she reads whether on the Internet or not.  Sure, it would have been more useful to me if I had your training and a subscription too all of the best peer-reviewed medical journals…but I don’t.  My foibles online led us to where we are while the physicians we went to left us in the dark entirely.  Are you suggesting we take our daughter to yet another specialist?  That’s what I would have expected the doctor we saw to suggest…but they didn’t.  BTW, Phadia would happily argue to the scientific community the accuracy of their Immunocap IgG testing.  We did have her skin-tested for 80 environmental allergies, as I understand it, the gold-standard for environmental allergies.  However, since the same testing can produce false-positives for foods we thought we’d short-circuit that route by doing the IgG test and remove what she reacted to from her diet, with the goal of reintroduce some of the avoided foods in time. For the record: given we know her environment, diet and level of sexual activity, we were able to rule-out the likelihood of the other causes you suggest might have produced similar symptoms.  

        • http://twitter.com/MartinYoung Martin Young

          You confuse sarcasm with reality, and being sarcastic to patients, including those not my own is not my nature..  We may have different perceptions of that reality, and that is why expectations are different.  And why being a doctor is not easy.  Nor is it being ill in any way.

          I really wish you well.  

          • http://twitter.com/whatscorrect don peterson

            Suggesting we might have considered that she was pregnant or had an STD was sarcastic.

          • http://twitter.com/MartinYoung Martin Young

            Dr Google suggested it, not me:)

          • http://twitter.com/whatscorrect don peterson

            Dr. Young – I know you went through years of training to become an MD and I know years of clinical experience  gives you a context no lay-person can have.  But if you’re suggesting that a person of reasonable intelligence cannot look at information on the Internet and discriminate between fact and fiction, I think that belies an unfounded bias in you.  When you shop online, or read car reviews, read about history, politics and science or about any complex topic, a person with an education and a reasonable mind can sort out the wheat from the chaff most of the time.  We make calculated judgment calls every day based on our own experiences, knowledge and education.  Do you really know the difference between an Intel and an AMD microprocessor?  Do you know why E85 fuel is better or different from pure gasoline?  Do you know why shale oil is more or less valuable than light sweet crude or more or less easy to extract form the ground?  Do you know why extra virgin olive oil is called extra virgin or why or how stock options are priced the way they are?  You might THINK that the providence of all things medical is in the physician because you’re the only ones capable of giving objective medical advice based on your training and experience.  But I would venture to say that you make what you consider to be informed decisions about many things every day on which you have no didactic or practical training. 

            Frankly, medicine, unlike almost every other industry, does a horrible job of sharing best practices and outcomes data.  For example, mIllions of diagnostic imaging procedures are performed each day, at a cost of millions of taxpayer dollars.  Yet, the symptoms and diagnoses are not readily shared between physicians for the purpose of learning from one another, developing best practices or measuring outcomes based on these diagnostic procedures.  In fact, because of fear and a lack of understanding of the actual HIPAA statutory requirements, physicians protect their patient and treatment information like Fort Knox protects our country’s gold reserves. Some sharing may go on within a given facility or institution, but no large-scale sharing (or vetting) of diagnostic procedures and outcomes exists for all to see.  Advancements in treatments and a complete understanding of outcomes related to treatments is impeded by this over-zealous protectionism that’s a direct result of a lack of understanding about the law.  Same applies to Stark, anti-kickback and anti-markup.  Physicians think they know, but they really don’t.  You have no legal training yet seldom seek the advice of a legal professional to help you interpret these rules.  So, you swing the pendulum too far in the direction of protectionism and thus limit the industry’s ability to advance based on the knowledge locked up in the data you anxiously cling to. The Internet is here to stay.  Rather than attempting to demean it’s value, why don’t you make it your mission to improve the ability to “OBJECTIVELY sift out the information when looking for a diagnosis??”

          • http://www.consentcare.net/ Martin Young

            I agree wholeheartedly with much of what you say.  But what about those who are not intelligent enough to make a distinction?  Dr Google is available to everyone, not just those with discernment, and the potential for harm is still there.
            I’m not saying for a moment it should not be available.  If you look at my initiative http://www.consentcare.net and read about the thinking behind it, you will see we are really on the same side in fighting the negativism and protectionism you speak about here, and in keeping any person fully informed at all stages of the medical process.

            In fact I believe it is the only way to transform medical practice in a win-win manner for all.  So our goals are the same.

  • http://www.facebook.com/profile.php?id=1293155286 Jennifer Burke

    Maybe if those ‘real live doctors’ actually did treat all patients based on “information tailored to our history, environment, and the socioeconomic and external pressures on us, and the fine nuances of our symptoms, dissected and probed” instead of not listening to patients and letting bias get in the way of listening and providing effective treatment, we wouldn’t need “Dr. Google”.

  • Anonymous

    The patient and the physician can have different interests at heart.  The physician (not his fault) needs to follow that “standard of care” that is in accordance to our culture’s expectation of perfection in healthcare and it means never, ever missing anything – even that one in million rare condition that presents atypically.  Therefore every bump on the head gets a CT scan and every complaint of chest pain – even with a normal EKG and bloodwork in a thirty-year-old - gets a further workup.  All the physcian cares about is not missing that rare hematoma or MI – not essentially unnecessary exposures to radiation(not to mention the huge medical bill that some of us with high deductibles would have to pay.)   The cancer would show up years from now when the doctor is out of the picture.  A $5000.00 bill shows up that you cannot pay and eventually threats to take you to court.  Only the patient needs  to worry about the bills and the cancer risk.

    What reputable medical sites on the internet do for me is present information without the bias physicians have (again, through no fault of their own)  so I can make a decision to undergo a test or procedure.  That’s just the way I deal with it.  It’s not perfect but what in life is?

  • Anonymous

    Doesn’t the medical community change its recommendations over the years?  Wasn’t irradiation of infants’ thymus glands and antibiotics given for every inflamed eardrum in otherwise symptom-free babies common in days gone by?  Does every physician stay on top of the latest research?  How can PCP’s be up on everything?  It’s impossible.  At least with access to the latest research a patient can ask questions.

    I get a little wiggy when someone even hints at discouraging people to not educate themselves.  Unhindered access to good information is important – the focus should be on guiding patients to reputable websites and clarification by the better educated, more knowledgeable physician.  The internet has been an AMAZING educational tool even if it has also provoked some anxiety in hypochondriacs.

    • http://twitter.com/MartinYoung Martin Young

      I did not for a moment suggest people should not educate themselves.  Self – diagnosing is the issue.  If it were possible using the internet and Google with a reasonable degree of safety, there would be little need for many medical professionals.  How can a patient self examine?  Can you look in your own ear, for example?  Or own colon?

      • http://www.twitter.com/alicearobertson Alice Robertson

        But…it does sorta look like you are discouraging patients from venturing out? I like your tongue and cheek….you must be of British heritage? I am….married to a British citizen…thankfully, it’s not curable….not that I would seek a cure….it’s too much fun…but that said…let us, as patients be a bit cheeky….it seems for the average patient your heels are a bit dug in….of course we can’t look in our own ear….but we can buy a scope and study and have the ability to see exactly what you do….and studies show antibiotics often aren’t in order for ear
        infections….so, bloody hell…why do we need you for? Ha! The
        colon? I get yearly scopes…I phone the doctor she orders
        it…..why can’t I do that? How does her MD and all those years

        of study make ordering a test so significant?

        I really do not think doctors are doing a good PR Job against Dr. Google….I am still convinced a doctor should know what Dr. Google is recommending….embrace it…befriend it…….Facebook ‘em….he’s probably going to be around longer than you. Patients see him/her/it as a plus….not the whole deal….but attractive….free….very difficult for the Average Joe to compete
        with…are you worried that two is company…three is a crowd?:)

        And…..just to get cut you off at the path ….I have never had an STD….just ask Dr. Google…..now that guy is the real Doctor McDreamy! ha!

        • http://twitter.com/MartinYoung Martin Young

          I’m South African but of British colonial extraction :)  My many posts on KevinMD support patient education and empowerment, but point out the risks along the way both to doctor and patient.  In this post, I use a real experience of a person close to me to point out what was a potentially damaging situation.

          In no way do I think medical information on the internet is a bad thing.  I think using it as a substitute for a real doctor is potentially dangerous, as do many other doctors.  There is no substitute for training and experience in navigating the thousands of possible things that can be wrong with someone, and narrowing it down to an accurate diagnosis.

          Google and other search engines are very useful as paths to additional information sources, patient education, keeping up with new options, and I support that entirely.

          • http://www.twitter.com/alicearobertson Alice Robertson

            Fair enough…in truth, if I were a doctor I would probably feel as you do….but I do hope medical schools teach to broaden the horizon….because patients are going to self treat….it is a given. I am studying thyroglobulin levels, lymphs….I am discouraged…two doctors disagree…but there are territorial fears….but territorial fears…to me…only relate to my daughter’s body…not my career…sometimes there are no easy answers….and even brilliant Dr. Google can’t help.

            Thank you for the clarity….you are certainly patient.

  • elizabeth52

    I thank the internet with providing me with the resources right there in front of me to make informed decisions about cancer screening. Women don’t get honest and complete information, we get spin and an order to screen – even coercion is permitted in the States and Canada – for an ELECTIVE screening test and unnecessary and potentially harmful routine gyn and breast exams! If you don’t agree, and not only to screening, but over-screening, then the doctor is likely to hold your birth control, HRT and even migraine meds – some decline all non-emergency medical care. It’s clear to see how the medical profession views women and scoffs at their legal and ethical obligation to obtain informed consent before screening.

    Those coercive measures were stopped here (in Australia) in the late 80′s (from memory) although many doctors still use the consult room to pressure women into testing and some will still present cancer screening as a prerequisite for the Pill BUT, few would be stupid enough to refuse to provide a script. (if the woman happened to know her rights and declined the test) That sort of conduct would mean the Medical Board…I’m not sure how your doctors continue to get away with it. The tide is turning though, thanks to Dr Robert Hatcher, Dr Carolyn Westhoff, Dr Gilbert Welch, Dr Joel Sherman and others.

    Anyway, the internet and Dr Google led me to medical journal articles and to discussion in the UK and Finland, where many doctors and other advocates have put informed consent for women squarely in the public eye – they’re forcing change…and challenging misinformation and unethical conduct. The UK, NZ and Australia all make target payments to GP’s for pap testing, yet the UK changed the payments system a year or so ago – they no longer rely on screening a certain % of women. Our doctors continue to receive these “undisclosed” target payments, which create a potential conflict of interest. No one says a word…

    Prof Michael Baum, UK breast cancer surgeon, who helped set up the first breast screening clinic, is now calling for the program to be scrapped, after more damning evidence was released…the fall in the death rate for breast cancer is about better treatments, and NOT screening. Screening may be harm for no or little benefit.
    http://www.guardian.co.uk/commentisfree/2011/aug/02/breast-cancer-screening?INTCMP=SRCH (the link to the research is in comment 3 or 4)

    The risk of over-diagnosis in breast screening is serious and still hidden from women here…the brochure doesn’t mention it – it’s all very one-sided with the emphasis being govt-set screening targets and protecting these expensive programs, NOT women. The screening groups are pretty effective in silencing and dismissing any critics, but as the UK has shown, there is safety in numbers…the NHS knows it’s being watched and that makes a huge difference. No one is keeping our programs honest and accountable…

    Our cervical screening program is excessive and harmful – there have been calls (locked away in medical journals) for over a decade suggesting change to provide some protection for the healthy population of women, the more than 99% who’ll never have an issue with this cancer – and to reduce the 77% lifetime risk of referral for a colposcopy/biopsy – massive over-treatment for a cancer with a lifetime risk of 0.65% and to “possibly” help fewer than 0.45% of women.
    The rights of a few should never override the rights of the vast majority.
    I say “possibly” because there are no randomized controlled trials for pap testing. The 0.45% figure comes about after you take out false negative cases, and consider other factors had this rare cancer in natural decline before testing even started – more hysterectomies, better condoms and hygiene, fewer women smoking, less STD etc
    The referral rates in the States are even higher…

    Yet we STILL screen young women, even though long-standing evidence shows they don’t benefit, but are exposed to high risk from false positives and over-treatment – which can damage the cervix and leave them with issues – cervical incompetence or weakness, infertility, cervical stenosis, miscarriages, high risk pregnancy, premature babies, more c-sections, psych issues etc…
    We should not be testing women under 30 – no country has shown a benefit after decades of testing#, but all have evidence of harm…the risks of a false positives are very high for women under 30 and especially under 25;
    AND we keep testing 2 yearly, KNOWING this greatly increases the risk for NO additional benefit. Finland has the lowest rates of cc in the world and sends the fewest women for colposcopy/biopsies – they offer 7 tests, 5 yearly from age 30. It’s also clear that HPV testing could be used to release low risk women from pap testing altogether# and reduce the number of pap tests for others, that in turn, would reduce over-detection and over-treatment.
    “Cervical cancer screening” in “Australian Doctor” July 2006 by Assoc Prof Margaret Davy and Dr Shorne.#

    Thankfully, I was aware enough to smell a big fat rat and spent days in the medical library reading up, almost 30 years ago now, followed by a watching brief made easier by Dr Google. I made an informed decision, as a low risk woman, not to screen and more recently declined breast screening. Both decisions made on the basis of information that is not released to women. (thanks to Prof Baum, Dr Welch and others)
    More and more it’s a question of those “in the know” making informed decisions, often with the help of Dr Google, and women being herded into screening, having been misled or being pressured, both without informed consent…that is NOT screening, but about power, control, profits and politics.

    Thankfully, Dr Google is enabling more women to get to the truth, but we’re still waiting for ethical doctors with a conscience to take on these programs – to protect women from harm and demand our right to make informed decisions about testing and preventative health care.
    I’d urge every doctor to take the advice offered by a Scottish GP, Dr Margaret McCartney in, “Doctors should not support unethical screening programs” BMJ and “We’re in trouble over screening” at her website. It’s heartening to see most of the comments to the BMJ article agree with her…some doctors “get it” and are determined to make a difference and protect their patients from these programs.
    Let’s hope that trend continues….so, I say…thank goodness for Dr Google!
    http://www.bmj.com/content/343/bmj.d4592.extract

  • http://twitter.com/whatscorrect don peterson

    Consentcare is a great idea and I hope physicians will use it…what has been your success thus far?  I too have an initiative to accomplish the sharing of diagnostic imaging studies that I mentioned above although we have yet to launch.  My email is don@utilimed.com.  If you will send me your email I will send you back a copy of a PowerPoint that explains our efforts.  

  • Pamela Curtis

    Dr. Google has been more correct in my diagnosis and provided more information than any of my human doctor.I researched my original symptoms and told my doctors my thoughts. They didn’t believe me. One ran a test “just to set [my] mind at ease” to assure my I didn’t have what I was claiming. But I did. Dr. Google was right: secondary adrenal insufficiency.I got a complete pamphlet on adrenal insufficiency from the UK published by doctors for their patients. I never got anything like that from any of my doctors here. And I learned SO MUCH about how to better manage my disease. 

    Before you go poo-pooing Dr. Google, you might want to research their success rate. Dr. Google can spend as much time with me as I require. Dr. Google isn’t condescending or patronizing. And working with Dr. Google has substantial  positive results. 

    Where else are patients supposed to educate themselves? Y’all don’t have the time.

    Heck, how do you think I found *this* site? 

    • http://twitter.com/MartinYoung Martin Young

      I am pointing out a serious problem many people experience when they google their own symptoms.  This is not to say for a moment that some people do not get it right when their doctors are wrong.  They do.  And sensible doctors realize this and welcome it.  But I think it is part of a doctor’s responsibility to point out risks in all areas of healthcare when they become evident.  And I have, as have many other doctors.

      Surely you don’t think Dr Google can replace all your doctors, do you?  That you can do without them completely?

    • http://twitter.com/MartinYoung Martin Young

      How could anyone research Google’s ‘success rate’ or ‘failure rate’ for that matter?  That’s the whole problem!  Unlike a drug that has to be tested and retested and measured against other drugs and placebo over years, there is no litmus test for how Google helps or hinders medical care.

      My belief is that the internet is probably better than nothing for self diagnosis, and definitely helpful for self education after a diagnosis is made.  But I cannot see how anyone could do an unbiased study of the question and come up with a definitive answer….

  • Anonymous

    So the family doctor missed the anxiety?  So Dr. Google was wrong and Dr. PCP was wrong and you think Dr. Google was the failure?

  • Espiridion Mendez

    I am a physician assistant licensed in Texas and Illinois. I am trying to get my virtual physician assistant business of the ground and was looking for physician clients. I think a service like mine (where I can do patient call-backs and call in medications for the physicians) can actually help physicians so that you don’t have patients using Dr. Google late at night. Let me know if I can help your practice. espiri4604@gmail.com. I also have a Twitter account @student_md_PAC:disqus .

  • http://twitter.com/MartinYoung Martin Young

    Family doctor was correct in this instance, but still referred to a neurologist. You should notice I do not condemn Dr Google outright – I point out an example of serious failure and misinformation. As many people do when they talk about doctors – especially on this site:)

    • Anonymous

      I don’t know what you thought but you wrote, “worried family doctor.”  To me that is a lot more frightening than reading some information on the internet that may mean something serious is wrong.  Three weeks of anxiety waiting for the neurologist believing you have a motor neuron disease and your doctor doesn’t share with you he thinks its anxiety?

  • Anonymous

    Perhaps investigating symptoms with Dr. Google can produce anxiety by putting possibilities on the table that are scary.  The same can be true for a trip to the doctor.  I had horrible anxiety when my doctor recommended an EGD to make sure I didn’t have cancer.  After waiting three weeks, the EGD showed nothing was wrong.  

    Would I have been better off not seeing my doctor with my symptoms because he might suspect something bad?

Most Popular