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Wednesday, December 6, 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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7 comments:

Mark said...

Hello Andy,

That's awesome. I'll be checking it out within the next few days and
hopefully within a week it'll get it's own post. I'm surprisingly a
little backed up at the current moment and my midterms aren't helping in my blogging ;)

Thanks for the email.

Mark Klukowski

Anonymous said...

Get 'em tigers. Google is reaching on this one. No diggity.

Andy Hadfield said...

Reply from Google. A month later :)

Thank you very much for the feedback. While we are unable to provide specific responses to the feedback we receive, we do read it and appreciate it -- our best ideas often come from our users! We are
especially grateful for feedback from clinicians. We are working hard to make our products more useful to patients and clinicians alike.

Best wishes,
The Google Health Team

Anonymous said...

Google medical could be a cause for lots of Hypochondriacs.

http://www.overseastreatments.com

Anonymous said...

I know this is an old post, but I feel the need to point out the medical inaccuracy in the post. Cystic fibrosis does NOT occur mostly in boys!!!!! It is a recessive condition and therefore both boys and girls can get the condition. I just find it funny that he writer states that the internet is wrong and then publishes incorrect information on the web himself. And the list of potential causes is a correct list of potiential causes, but as the writer points out, most can be immediately discarded in his patient's case. But I ultimately agree that patients have to be careful where they get thier information.

SA Doc said...

Thanks for pointing that out. Post call my brain was obviously merging with other recessive diseases.

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