Dr. Grumpy and Dr. Google

The monthly Costco Connection magazine was left in my lobby recently, and on a quiet day I glanced through it. It featured an article asking whether or not patients should seek medical information online.

Comically, they decided to get pro and con opinions from 2 individuals- NEITHER OF WHOM IS A MEDICAL DOCTOR!

Really. The 2 experts they quoted were Dave deBronkert, who's a "voluntary co-chair for the Society for Participatory Medicine" and Judy Segal, who's an English professor at the University of British Columbia.

Now, I have nothing against either of them. I mean, they are both obviously intelligent, highly educated individuals. But I think it's pretty damn funny that the writer didn't feel it was worthwhile to, say, ask a medical doctor.*

So, Costco mag, here's my 2 cents worth.

First of all, this question is moot. Like atomic energy, cloning, and stem cells, this genie ain't going back in the bottle. People already DO look stuff up online, and unless the internet completely crashes, will continue to do so.

Second: I suppose most of you are expecting me to be adamantly against my patients looking up stuff. But ya know what? I'm not.

Most patients actually DO benefit from learning more about their diseases online. At least half of what I tell them in the office won't get absorbed anyhow. And I don't have the space to keep a million little "Living with Schnorkfloodle's Syndrome" pamphlets lying around. So I refer them to what I consider to be reputable websites (not BigPhilsguidetoParkinsonsDiseaseandroofingmaterials.com).

But there are also the cyberchondriacs. They type a few symptoms into Google, and voila! They are now convinced they have whatever got the most hits (for neurology purposes, I'd estimate that 90% of search engines lead to a self-diagnosis of MS).

It's this group that drives me nuts. They want me to prescribe treatments that are only available somewhere far away (like Senegal). Or they bring in a HUGE stack of information written by a Holostic Reflexologist on a site that has absolutely no valuable medical info at all (but because it has nice graphics it MUST be true). Or they want me to magically enroll them in some study being done in another state that I have absolutely no connection to.

This is where the real problem starts. People who don't have medical knowledge make the scary leap from symptoms, sometime quite vague, to fixating on whatever the internet says they MUST have. Medicine is a process of collecting data from several angles and working out probabilities. If you don't have the training to do that, the information in front of you can be terrifying. Not only that, most people don't understand the difference between various phases of drug trials, so a treatment that's in development suddenly becomes one they think is available.

And here's what really grates me: if these people need a car fixed, they'll do a shitload of research to find a reputable place. They wouldn't dare just grab some random stranger and ask them to repair it. But when they have a health issue they'll take the word of a pet mausoleum architect with a nice internet site over that of a reputable, trained, medical professional.

So here's the take of an uninformed yak herder pretending to be a neurologist: Is it okay for patients to learn about their health issues on the internet? Of course!

As in everything else, though, it depends on the source of the info, the person reading it, and what they do with it.

Let the buyer beware...

*I'm sure I'll hear from those of you who believe this is because we docs are secretly conspiring against you as part of some giant medico-pharma fiendish plot, and therefore can't be trusted.