Forgot your password?
typodupeerror
Image

Doctors Seeing a Rise In "Google-itis" 368

Posted by samzenpus
from the sounds-like-rickets-to-me dept.
It's one of the fastest-growing health issues that doctors now face: "Google-itis." Everyone from concerned mothers to businessmen on their lunch break are typing in symptoms and coming up with rare diseases or just plain wrong information. Many doctors are bringing computers into examination rooms now so they can search along with patients to alleviate their fears. "I'm not looking for a relationship where the patient accepts my word as the gospel truth," says Dr. James Valek. "I just feel the Internet brings so much misinformation to the (exam) room that we have to fight through all that before we can get to the problem at hand."

*

This discussion has been archived. No new comments can be posted.

Doctors Seeing a Rise In "Google-itis"

Comments Filter:
  • Rarity score (Score:5, Insightful)

    by UndyingShadow (867720) on Monday May 17, 2010 @02:33PM (#32241490)
    I think every website that lists all these varied diseases should put a rarity score next to each illness. That way when you think you've got Wilson's disease, you can look and see with a simple number how unlikely it is.
  • Indeed, but... (Score:4, Insightful)

    by dmbasso (1052166) on Monday May 17, 2010 @02:37PM (#32241572)

    for those scientifically oriented, and aware of our natural cognitive bias [wikipedia.org], it is a fantastic tool to pin down the real problem, bringing relevant information to discuss with a doctor.

  • House, MD-itus (Score:2, Insightful)

    by ghetto2ivy (1228580) on Monday May 17, 2010 @02:38PM (#32241600)
    I think House has inspired a bit of this as well.
  • I have a feeling (Score:3, Insightful)

    by GilliamOS (1313019) on Monday May 17, 2010 @02:42PM (#32241670)
    That is has been a problem of sorts since the bombardment of TV and print ads for Rx drugs. Why do they feel they need to advertise them? You can't just go and buy them OTC.
  • Re:Rarity score (Score:5, Insightful)

    by treeves (963993) on Monday May 17, 2010 @02:43PM (#32241696) Homepage Journal
    Nice idea, but it probably wouldn't work very well. One, people are notoriously bad at estimating risk. Two, if you really think you have the symptoms that fit a particular disease, you'll just assume that "yes I really am that one person in 2.5 million that has this disease". Three, if one in a 100,000 is a "high-risk disease", because very few conditions have higher rates, it'll make it easier to convince yourself that you have it. Four, there is no fourth point.
  • by StikyPad (445176) on Monday May 17, 2010 @02:45PM (#32241750) Homepage

    Oops, I believe they were actually elevated levels of enzymes. Regardless, they were abnormal when symptoms were present, and returned to normal after discontinuing Yaz.

  • by Qubit (100461) on Monday May 17, 2010 @02:50PM (#32241872) Homepage Journal

    ...if Medicine wasn't such a members-only club. There's the "In" crowd and then there's the "Rest" of us.

    Take other fields.... writing, education, programming, painting, online stock trading -- anyone can hop online or go down to their local bookstore, get How-To books, and start to do actual work in hundreds of different fields. But not in medicine.

    Sure, you can learn some First Aid, and maybe even some more advanced techniques, but eventually you'll have to go to medical school to become a nurse or doctor, or at least attend weekly courses to become an EMT. And there are some safety reasons for training people in this fashion, as well as restricting access to certain drugs to only those people who demonstrably know their effects and interactions.

    But just because there are some good reasons, some of the time, to lock up some medical knowledge or access to the tools of the trade, doesn't mean that there won't be hundreds if not thousands of motivated individuals that want to try to tackle their own medical problems the same way they do home improvement projects.

    Quoth the doctor:

    "I just feel the Internet brings so much misinformation to the (exam) room that we have to fight through all that before we can get to the problem at hand."

    So here's one for you: Why can't you fight that misinformation before the patient even steps foot in the exam room? Why don't doctors create peer-reviewed, well-written websites to counter all of the confusion and pseudo-science currently available online? Won't patients gravitate to the more prestigious sites, especially if doctors point them there?

    But I don't think that doctors want patients to ever try to self-diagnose, so they won't ever put this information online. Whether or not the doctors have the patient's best interests in mind, this creates a rift between the two parties, and does little to advance patient-centered health care.

  • by BobMcD (601576) on Monday May 17, 2010 @02:50PM (#32241880)

    This.

    The dirty truth that's seldom told is: Your doctor doesn't know any better than you do. He or she is making highly educated guesses, and that's about the end of it.

    Your tribal witchdoctor of years past had less knowledge, but was doing the exact same thing. Science came along and made medicine less of a guessing game, but it can never remove it completely.

    From TFA:

    No longer is it between a doctor who knows all and a parent who knows nothing.

    Show me the doctor who genuinely 'knows all' and I'll show you a miracle worker. It simply doesn't work that way, never has, and I'm sorry if it makes some practitioners sad that the patients have more tools.

    As in the case above, however, this is genuinely a good thing for us all.

  • by Anonymous Coward on Monday May 17, 2010 @02:51PM (#32241886)

    ..one person actually cares about the patients health. Is it the one who made an appointment to go through an uncomfortable examination because they felt like something was wrong, or the one trying to squeeze as many credit ca... people through his business in an hour as possible?

    Do your own research people. Go to your doctor armed with information, and don't let them brush off your concerns. Will your doctor like it? No, he went to medical school, and who are you to think you'd know something about your body that he didn't see in the 1.3 minutes he spent in the room with you so far?

    To be fair, TFS seems to promote the idea of the doctor actually spending a few minutes with the patient doing the same types of searches they were doing at home, and when my daughters pediatrician did this for me and my wife around the H1N1 scare, we left feeling much better, so, I don't know.. am I building a strawman? I've heard it both ways.

  • by Grygus (1143095) on Monday May 17, 2010 @02:51PM (#32241892)

    Not sure that's a counter, actually; I don't think that's the kind of behavior doctors are concerned about. When your wife found the evidence that she may have been misdiagnosed, she went to her doctor to confirm it and get his opinion; she didn't dismiss him as a quack and go all homeopathic on him, or assume that he was an idiot and stop taking his advice seriously.

  • by BurningTyger (626316) on Monday May 17, 2010 @02:54PM (#32241948)

    Family doctors are pretty much useless. Why do I need to book for an appointment, wait like 30-40mins at the clinic even though I have an appointment, and only able to talk to the doctor for 5mins?

    I went to do my annual check-up with the family doctor a year ago, and I complained to him about my day-time sleepiness. The doctor simply dismissed it as "bored at work". I basically had to google the symptom myself afterward to discover that I might have sleep-apnea, and then book another appointment to tell the family doctor to just give me a referral to see a sleep specialist to do more comprehensive test. Lord and behold, my self-diagnose was confirmed by the sleep lab, and I even knew that the treatment would be CPAP before the sleep doctor suggested it.

    The point of the story is, yes, there will be paranoid people who suspect they are dying of rare diseases because of their headache and whine to their doctor all day. For most people, they are better off googling their own symptom first, get a general understanding of what could be the cause of it, so that you can better talk to your family doctor on what test to do and which specialist to see.

    Hey, you don't go to see a car salesman before doing your homework, why go see your doctor without getting a better idea of your own health?

  • Re:Google-itis (Score:2, Insightful)

    by nevillethedevil (1021497) on Monday May 17, 2010 @02:54PM (#32241952) Homepage Journal
    Depends on how you define "problem"
  • by Stenchwarrior (1335051) on Monday May 17, 2010 @03:09PM (#32242274)

    So here's one for you: Why can't you fight that misinformation before the patient even steps foot in the exam room? Why don't doctors create peer-reviewed, well-written websites to counter all of the confusion and pseudo-science currently available online?

    Because then the Dr. is liable for any information that he may have "pointed" you towards. Even peer-reviewed information, while it may cover the majority of the seekers' symptoms more accurately than the pseudo-science, there's that small percentage that would wind up taking the advice and be wrong...then there's a lawsuit.

    More importantly, patients might be less likely to come in for an exam based on the information at-hand, thus the Dr. could not bill the standard 992XX code for their $85 office visit reimbursement from the insurance company. Hey, a guy's gotta eat.

  • Re:Hypochondria? (Score:5, Insightful)

    by PakProtector (115173) <cevkiv.gmail@com> on Monday May 17, 2010 @03:12PM (#32242312) Journal

    I don't think you understand. Your wife is a rarity.

    I am not a doctor. I am studying to be one. I talk to a lot of doctors. The patients who come in who have diagnosed themselves correctly, or close to correctly, such as getting the 'genus' of a disorder or disease correct while the 'species' is incorrect, are so rare that they tend to remember them.

    Compare it to a Help Desk worker -- how many callers, per centum, do you think that Help Desk worker gets who would call up, have a correct or nearly so idea about what is wrong, and be calling only to get instructions on how to fix it?

  • by Anonymous Coward on Monday May 17, 2010 @03:13PM (#32242358)
    I prefer to be informed.

    I really hope my sarcasm detector is just off-kilter today, but...

    We're talking about Googling medical conditions, not Googling medical conditions and following it up with 8+ years of med school. There's no realistic way a lay-person with a net connection can properly be informed before meeting with their GP, pow-wowing with their OB/GYN, or rushing to the ER. They can fill their heads with all the textbook phraseology they wish, but without proper training it doesn't mean a damn thing.
  • by SakuraDreams (1427009) on Monday May 17, 2010 @03:13PM (#32242362)

    ...if Medicine wasn't such a members-only club. There's the "In" crowd and then there's the "Rest" of us.

    Take other fields.... writing, education, programming, painting, online stock trading -- anyone can hop online or go down to their local bookstore,

    I'm a doctor.
    You mean a multi-billion investment fund will take my advice where to invest their clients' money? I should just email them after having read some books?

    Or perhaps the city will let me design a bridge? Or maybe I could learn to fly on Microsoft Flight Simulator and give my airline pilot advice during the next turbulent flight I encounter?
    Maybe I should barge in and tell the magistrate in court what they should do - I've seen Perry Mason do it and read some books.

    "I just feel the Internet brings so much misinformation to the (exam) room that we have to fight through all that before we can get to the problem at hand."

    It's very good advice. People are not specialists. You can't be a stock broker or a computer programmer and expect to be a doctor too. It's nice to be able to read up information but don't presume you will understand it, let alone be able apply it.

    So here's one for you: Why can't you fight that misinformation before the patient even steps foot in the exam room? Why don't doctors create peer-reviewed, well-written websites to counter all of the confusion and pseudo-science currently available online?

    There are many such sites. In the UK the NHS has sites with information for patients. In the US the CDC (among other agencies) has similar sites. There is also WebMD. http://www.webmd.com/ [webmd.com]
    It's usually helpful to start with your local Health Ministry websites and work from there. As said in the UK, this would be NHS.
    There's also the Health on the Net Foundation which 'certifies' sites which contain credible medical information. http://www.hon.ch/ [www.hon.ch]

    The knowledge is there already or do you want you doctor to spell it all out for you. Should he also take you down to your local library to point out the right section for you?

  • Re:Rarity score (Score:3, Insightful)

    by ScentCone (795499) on Monday May 17, 2010 @03:23PM (#32242556)
    Polls also show that everybody thinks they one of the top 10% of drivers that are the best, safest, and most experienced behind the wheel. People - at least 93% of them - are just about always wrong about anything involving statistics.
  • by Anonymous Coward on Monday May 17, 2010 @04:00PM (#32243278)

    The dirty truth that's seldom told is: Your doctor doesn't know any better than you do. He or she is making highly educated guesses, and that's about the end of it.

    Your tribal witchdoctor of years past had less knowledge, but was doing the exact same thing.

    "Your tribal witchdoctor of years past" wasn't making highly educated guesses based on ~7 years of formal medical education.
    On top of all that, in 42 of 50 States, they're reading medical journals and attending conferences/lectures
    to keep up the CME [wikipedia.org] credits they need to retain their medical license.

    If you want more time with your doctor, pay more.

  • Re:Hypochondria? (Score:2, Insightful)

    by Anonymous Coward on Monday May 17, 2010 @04:09PM (#32243438)

    I don't think you understand. Your wife is a rarity.

    I don't think you understand. The doctor's job is to diagnose the disease. It's not to come to a conclusion based on the limited amount of effort they want to put towards it and then ignore any evidence to the contrary because they don't think the source could possibly know more than them. I've done computer support. The diagnosing part is a lot more similar than most people give credit with 2 glaring exceptions. The first exception is usually lives aren't at risk diagnosing computer problems. And second is with computer problems whether you get it right or wrong is much better defined and much more accounted for. If you fail to fix the computer it's obvious and you're likely not to have a job for long after more than a few failures. That's not the case for medical professionals even though the consequences of mistakes or failure are MUCH higher.

    When trying to figure out a computer problem we don't get the luxury of asking a few questions then declaring what the problem is and walking away cause if we're wrong the computer is still not going to be working. We actually have to resolve the issue and fix it. This requires a great deal of detective work and critical thinking including being critical of one's own conclusions and the resulting prejudices. It also requires getting the information required to solve the problem from the people who have it despite their best efforts to not provide it or to provide misinformation. Whether the wife in the example above was a rarity or not all information should be taken into account when making a diagnosis. Should you believe all information? Hell no. But you should follow up to point of convincing yourself that the information is not important rather than just dismissing it out of hand. Unfortunately way too many doctors take your attitude and often end up missing the critical bit of information that was vital to a correct diagnostic as in the case above. Far too many doctors think they're much smarter than they are and assume other people are dumber than they are. Note that the opposite is true of intelligent people. Intelligent have a much greater tendency to underestimate their own intelligence while over estimating that of others.

  • by jurgen (14843) on Monday May 17, 2010 @04:11PM (#32243496)

    Ok, I don't have any hard data, but it seems to me that in reality today for every patient with mis-informed "Googleitis" there are ten or more people who are getting better medical care because they are informed about their condition or even have already correctly self-diagnosed. Some of the comments right here to point.

    But doctors are upset because they are not used to having informed patients. They are used being the godlike arbitors of secret knowledge whose judgement will be trusted 100% because of their degree. But in reality of course they are human and all too fallible, and even more so nowadays that they are increasingly simply pharmaceutical salesmen rather than healers and don't really have or take the time to actually know their patients.

    Before doctors found it easy to be confident... because hardly anyone ever questioned them. Now things are getting a bit more difficult. Poor doctors? I'm finding it difficult to be sympathetic.

    There may be a lot of information of questionable quality on the Net, but overall I have not a shred of doubt that the empowerment the Net has brought to the individual in this regard has been a boon to public health.

  • by DarthVain (724186) on Monday May 17, 2010 @04:17PM (#32243624)

    Your health, your responsibility. Period. Many doctors can be dismissive, usually with good cause, that is their experience. However even good doctors can be surprised. None are suspecting that rare condition. The only way they will test for it is if you are insistent. Some not even then, in which case you shouldn't be afraid to see a new doctor. The internet is a powerful tool, and can be very useful for a savvy user. One just has to be aware that not all sites are reputable or of the same quality. Also there is a lot of things out there, and to not get worked up about what could be wrong with you and looking at worst case scenarios. Finally, your not a doctor, so using your own judgement and what you can glean from the internet, go see a doctor is you feel the need to. True story: I felt I was having trouble breathing and chest pain. This was dismissed as stress (I was young 30). However having read too much about worse case, quickly turned into panic attacks and anxiety making it worse in a sort of feedback loop. Anyway I figured it out, but it wasn't fun. During this time I remember talking to a friend of mine who gave me the speech about being your own health advocate, and being responsible for your health not a doctor. When she was younger (early 20's) she was dismissed by many doctors, but through persistence was diagnosed with cancer. Which she beat. However had she not been as persistant things might have been different. She was young, and healthy, and it was a rare diagnoses, but it happens.

    So I guess what I am trying to say is that:
    1) Ultimately your health is your own responsibility using the internet to help you is a good idea,
    2) However temper your imagination, and try not to get worked up about possible outcomes.

  • by Hognoxious (631665) on Monday May 17, 2010 @04:17PM (#32243632) Homepage Journal

    Your doctor doesn't know any better than you do. He or she is making highly educated guesses, and that's about the end of it.

    This is true - the human body is a darn complicated thing. And to be honest it's true of mechanics too - a car engine is darn complicated too.

    Nonetheless, in either situation, I'd take a highly (and appropriately) educated guess over an ordinary guess any day.

  • Re:Hypochondria? (Score:3, Insightful)

    by Znork (31774) on Monday May 17, 2010 @04:20PM (#32243690)

    Now, a bit of internet reading won't make me an expert, but during my consultation it allowed me to be an active participant

    Misdiagnosis is very common, rates around 10%-30% are often seen, so obviously a medical degree doesn't necessarily make one an expert either. Human disease is simply a far too varied field with far too many similar symptoms for doctors to have even a fighting chance to get it right much more than that with the time available for each patient.

    Researching on your own has shown to cut down the chances of misdiagnosis quite a lot; at least you can point out possible problems or alternatives that the doctor might have missed or forgotten, or point out symptoms that you may have thought insignificant at first.

    It would be nice with more refined diagnosis tools on the net tho; easily accessible and structured decision trees which can guide you through how to both rule in and rule out possibilities would make a good tool for both patients and doctors. Done correctly it could even cut down unnecessary doctors visits and/or increase chances of early discovery of some diseases.

  • by Anonymous Coward on Monday May 17, 2010 @04:30PM (#32243906)

    "Guessing"? To say that medical practitioners, as a whole, are "guessing" is incredibly naive. Does the bridge engineer guess on the load bearing capacity? Does the auto mechanic guess what the appropriate timing is on your timing belt? What about an airline pilot navigating from one airport to another and landing safely? No, no, and no. They use KNOWLEDGE, EXPERIENCE, TOOLS, and INTUITION.

    Likening these traits to a medical professional:

    • KNOWLEDGE: medical school, journals, CME
    • EXPERIENCE: rotations and/or residencies, practicing professionally
    • TOOLS: blood tests, ECG, CT, symptoms
    • INTUITION. The final one is gleaned through common sense, logic, knowledge, experience and tools.

    Guessing? While there may be those at the lower end of the spectrum that may lack in some of these areas, to generalize so is unfair and misinformed.

  • by Beomeph (1280022) on Monday May 17, 2010 @04:31PM (#32243942)
    I think what you're describing is valid for most of the internet at large. It's selection bias, where people who have had experiences where their own research has proven themselves right will post about their success online. What isn't reported equally is the 99% of cases where this didn't happen, or worse, the person was proven wrong. Of course I totally agree that being informed about your own health / condition is a very good thing and should be encouraged.
  • by Anonymous Coward on Monday May 17, 2010 @04:32PM (#32243966)

    The dirty truth that's seldom told is: Your doctor doesn't know any better than you do.

    Yeah, most doctors just spend those 12+ years or whatever it is in med school doing keg stands.

    If you mean know in the philosophical absolute certainty kind of sense of the word then of course you're right. But pragmatically, in general, if my doctor tells me I have skin cancer, I'm not going to look to google for a second opinion. Being an informed patient is a good thing, but being that annoying person who knows better because they "know how to use the google" seems like it could easily be counter-productive.

  • by Anonymous Coward on Monday May 17, 2010 @04:43PM (#32244194)

    So mechanics, airline pilots, bridge builders, and medical professionals all just SWAG their work first, then test it? The difference being that, with the exception of the medical professionals, the rest can "safely and ethically" test their work before harm is done? Whereas the MD just killed someone? While I'm not foolish enough to implicitly trust my doctors 100%, I certainly don't think they're just guessing.

  • Re:Rarity score (Score:1, Insightful)

    by Anonymous Coward on Monday May 17, 2010 @04:44PM (#32244202)

    Of course if everyone (patients and doctors) rule out "rare" diseases strictly on the basis that they're rare, then those who actually have a rare disease will get misdiagnosed. And, of course, the disease will, with a kind of circular reasoning, continue to be regarded as rare. Rarity alone is not proof of anything.

  • Re:Hypochondria? (Score:3, Insightful)

    by Jah-Wren Ryel (80510) on Monday May 17, 2010 @05:52PM (#32245332)

    I don't think you understand. Your wife is a rarity.

    Which is kinda the whole point. Most doctors - general practitioner types see the same thing day in and day out. 999 times out of a 1000 basic symptoms have basic causes. So when that 1 in 1000 comes through it is entirely too easy to miss it. Thus it is really the patient's job to double-check the doctor's diagnosis, after all it is the patient with the most to lose. Any doctor which does not accept and even encourage the patient to get independent confirmation is a bad doctor. Maybe they get it from a second opinion, maybe they get it from their own research. Either way, it's the patient's responsibility to follow-up and the doc's responsibility to take the results of those follow-ups seriously.

    Sure there are plenty of dumbass hypochondriacs out there, but if you treat everyone as if they are a dumbass hypocondriac by default then eventually you are going to get someone killed.

  • by Dhalka226 (559740) on Monday May 17, 2010 @08:35PM (#32247346)

    But just because there are some good reasons, some of the time, to lock up some medical knowledge or access to the tools of the trade, doesn't mean that there won't be hundreds if not thousands of motivated individuals that want to try to tackle their own medical problems the same way they do home improvement projects.

    Erm, what?

    Medical knowledge is not locked up. Nobody is stopping you from buying the exact same textbooks as the doctors. Nobody is stopping you from knowing pretty much everything a doctor knows. Pretty much the only thing you can't learn on your own is whatever you learn by cutting up a cadaver.

    If you're looking to dispense your own drugs, well, that's not going to happen, nor is it a case of "some good reasons, some of the time, to lock [it up]." It's a horrible idea in most cases, horrendously prone to abuse that people will literally die from. That is the same reason you don't get to practice because you passed the $70 Internet Doctor course. You're going to kill people. Lots of them. If you want to use your newfound knowledge, use it by talking to your doctor and having him run whatever test you want -- most doctors will capitulate even if they think it's stupid.

    Why don't doctors create peer-reviewed, well-written websites to counter all of the confusion and pseudo-science currently available online?

    People are dumb. Sorry, but they are.

    For starters, they believe things for stupid reasons including advertising, placebo effect, "my best friend told me so and he's smart," etc. Do you have any idea how many millions of dollars were made by "HEAD ON! APPLY DIRECTLY TO FOREHEAD!?" It's a ball of freaking wax. Same with most herbal supplements. Some of them work to some degree; most do not. Then there's things like vaccines causing autism, that some people just believe no matter how many peer-reviewed studies on well-written websites tell them otherwise. There's a show on HGTV calling "Selling New York" about high-priced real estate, where one guy brings in "[his] energy guy" to cleanse the bad energies out of an apartment before selling it. What can anybody possibly say to people like this?

    Second, I suspect he was trying to be nice. I think the problem is less the bad information as it is people making themselves paranoid. I have, as we speak, little rash spots on various parts of my body and a headache. It could be meningitis and I could be dying as I type. Or more likely, it could be allergies and dyshydrotic eczema since I know I have both. Many highly fatal diseases present as a cold. If people are Googling about it, it means they're already bothered by it enough that they don't think "get some rest and drink lots of fluids" is getting the job done. That's going to instantly tilt their perceptions toward something more serious than the most likely culprits, even with no particular evidence.

    Medicine is difficult, especially diagnosing a problem. Lots of things present as other things, and many of those "other things" are "wuh oh, you're dead." They're also uncommon. You have to use a blend of symptoms, tests (if available), previous history and just plain odds to make a diagnosis. Testing for every possible thing not only would be a collossal waste of the doctor's time and the lab's time, but also money on the part of patients and insurance companies (circling back around to patients). It's good that people are becoming involved in their own healthcare, but it doesn't mean it isn't ultimately a waste of time in the vast majority of circumstances.

    All that said: WebMD. Peer-reviewed, excellent source of information, excellent and easy way of getting a huge list of what you might have based on your symptoms.

  • Re:Hypochondria? (Score:3, Insightful)

    by the_womble (580291) on Monday May 17, 2010 @09:16PM (#32247652) Homepage Journal

    Of course they omitted them - it looks more like an Apple user that way.

  • by Dan Ost (415913) on Tuesday May 18, 2010 @08:45AM (#32251462)

    Doctors look at a situation, generate testable hypothesis, test those hypothesis, and monitor the results.

    If you don't think that's applied science, you are mistaken.

Help stamp out Mickey-Mouse computer interfaces -- Menus are for Restaurants!

Working...