Rabu, 06 Desember 2006

A Medical view on "Googling your symptoms"...

Andy's post (Google Health... some thoughts), although opinionated and not medically based - is correct.

I understand and support the notion that a patient HAS to be educated. They take their pills regularly, they look after themselves, they’re more compliant patients if they understand what’s happening to them.

But... What’s wrong with the Internet is that patients have no guidance on what they’re educating themselves with – what to hold onto vs. what to discard. They end up wrongly informed – which is far worse than not informed at all.

I worry about Google's content rating system. You’re asking non-medical, ignorant people to judge the relevance of medical content. There’s a reason doctors study for 6 years and then practice for 2! It’s like me trying to make a judgement on the performance of the latest BMW – I just don’t have a clue!

Prime Example. Had a patient the other day who’s 6 year-old daughter has rectal prolapse. She’s been seen by a GP and paediatricians and no sinister cause has been identified. Mommy went to the internet and looked up rectal prolapse – and of course - out pops the textbook list of causes. She then arrived at the Practice with her mind made up. Her daughter now had cystic fibrosis – and I should investigate accordingly. Cystic fibrosis is barely even a contender in this diagnosis btw.

Now. I had to explain to Mommy and her superior Internet knowledge that cystic fibrosis occurs in BOYS - almost exclusively! And that if there were any signs of cystic fibrosis – the signs would have manifested as increased mucus at the age of 2!

Two consultation sessions later, and a bunch of time wasted trying to explain to Mommy that just because it's on the internet – doesn’t mean its true... a mild example of what can go wrong with layman internet research.

Don’t believe me? Try it out for yourself. Go to Google.com. Type in “rectal prolapse”. Conveniantly, Google picks this up as a medical term and offers you Treatment, Causes, Diagnosis, For Patients, Alternative Medicine etc. etc. examples. Click Tests / Diagnosis. Result number 3 is E-Medecine. And there, for all to see and interpret, is a pretty damn scary list of causes.
- Advanced age
- Long-term constipation
- Long-term
diarrhea
- Long-term straining during defecation
-
Pregnancy and the stresses of childbirth
- Previous surgery
-
Cystic fibrosis
- Chronic obstructive pulmonary disease
-
Whooping cough
-
Multiple sclerosis
- Paralysis (Paraplegia)

This isn’t differentiating between age, gender or pre-existing illnesses – three of the most fundamental differentiators. That’s WHY doctors have consultations. To narrow down, or eliminate lists of causes before a proper diagnosis.

Little Susie is now a potential victim of Whooping Cough and Multiple Sclerosis – and if Mommy is paranoid enough… Chronic Obstructuve Pulmonary Disease (Translation: Emphysema. Do you really think the 6 year old has been smoking 20 cigarettes a day for 20 years?)

Empower the patient - definitely! But who's going to help us undo the influence of bad research?


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