Monday 08 Dec 2008
Matt McGee has been writing about a subject over at Search Engine Land that I feel is of considerable interest and worthy of discussion. His recent articles on Cyberchondria and Paging Dr. Google: Will Google Replace Your Doctor?, in effect, document the fact that people are increasingly turning to the Internet for medical answers with both good and bad results.
The obvious danger in using Google to diagnose yourself is that you may having nothing but the stomach flu that’s going around, but become convinced that you’ve got a terminal illness. No matter whether you are using a resource as authoritative as the Mayo Clinic or an aggregate adsense site, your symptoms have the potential to appear to match up with an almost limitless number of illnesses. You may cause yourself needless worry, up at 3 AM, coming to the conclusion that you’ve got a fatal disease when, in fact, you just ate something bad. At the same time, your reasonable concerns might be falsely allayed by an Internet site that tells you not to worry about symptoms when you should be visiting a doctor ASAP. Yahoo! Answers is riddled with lay people giving unqualified advice about medical conditions and a situation like this is almost certain to mislead some searchers, causing unwarranted stress or putting their precious health in jeopardy.
It Takes Fertile Ground To Create This Situation
Why would people trust their health to the web, knowing it’s the same thing that provides them with silly cat videos and Adwords ads for the latest fad diet? Anyone with a domain name and hosting can publish anything on the web, including their personal accounts of having been abducted by aliens. It takes a special situation that will lead adults to suspend their discernment and skepticism in order to put their trust in random documents published by unknown, unqualified sources, and I would propose that several factors are contributing to this phenomenon of paging Dr. Google.
1) Prolonged, chronic or mysterious health complaints can make a person desperate. Pain is especially apt to make a person reach out for relief and help wherever they can find it. Every day, Americans purchase ‘magic’ formulae to make them thinner, smarter, happier, healthier from unbelievably dubious sources whether they find them on the web or in the back pages of rubbishy magazines.
2) 50 million Americans are living without health insurance. This is a shameful situation for our country, and many families who can afford $60/month for Internet service cannot afford $600/month for health coverage. Once you’ve got the Internet, medical ‘advice’ is ‘free’. A lack of experience with the varied quality of content published on the web may make it difficult for people to determine whether Standford University or Bob’s Purple Pill Site is a more trustworthy source of medical information. It costs the same amount to visit either one of them and if you don’t have the money to see a doctor, it’s a pretty natural outcome that you’d like to get whatever help you can by diagnosing yourself with the help of Google.
3) Local medical services are disappearing in some areas. The largest city nearest to where I live is down to 2 hospitals now and may soon be down to one. There used to be 5 of them, when the population was much smaller. Doctors’ offices are critically understaffed – there’s nothing quite like being horrendously ill and hearing that, ‘doctor can see you 3 weeks from now.’ The fraud that is U.S. Health Insurance has driven many physicians to stop accepting insurance so that they can make a living, and locally, many have had to leave private practice in order to join corporate health care providers like Kaiser, leaving their patients without the personal care they once counted on. The Internet is always open and always ready to give your medical issues priority, no matter where you live.
4) There are a lot of crummy doctors out there. I had one tell me I needed to get a hobby when, in fact, I needed surgery. I’ve seen more than my share of doctors, and the majority of them have been, in my opinion, unfit to serve the public. Everything from dangerous misdiagnoses to atrocious communication skills await the US citizen who goes to the professionals for medical help. Having a medical degree doesn’t necessarily make you a gifted master of the healing arts and it is likely that insurance woes and understaffing are only exacerbating the disorganized and dissatisfying situation patients experience when seeking medical care these days. It’s a lot more comfortable using your mouse than it is sitting in a waiting room for an-hour-and-a-half in order to see a doctor you barely know for 3 minutes.
5) Too few doctors appear to feel a personal responsibility for their patients’ well-being these days. Long gone are the days when the country doctor made house calls to the family to take care of everyone from Grandpa to Little Billy. Rather, nightmarish insurance constraints and a constant barrage of sales calls and ad campaigns from pharmaceutical corporations stand between the doctor and the patient, preventing them from knowing one another as whole people. My personal experience with medical care has chiefly involved doctors quickly prescribing large quantities of the latest drugs for me, without working to find the root cause of symptoms or to understand my overall physical and mental health. Visits are rushed to the point that you come away feeling that the doctor needed to be someplace other than in the room with you, and that drugs are the answer to everything. It’s as though the doctor has changed roles with the pharmacist, rather than standing in the honored position of trusted overseer for your total well-being. The Internet doesn’t know you, either, but at least you know yourself while you are searching the web for medical advice, and you can take all the time you need.
It isn’t my intention to dispairage doctors as individuals, though I’m quite willing to utterly denounce this country’s current medical care/insurance situation. Doubtless people have had better experiences with professional medicine than I have, and I’ve even recently found a doctor I think is well above average in terms of her more holistic approach to human health. I am simply trying to point out why Americans may be especially prone to visit Dr. Google rather than an offline MD these days. I think my 5 reasons actually do present a pretty good case for why people would be seeking alternative paths to better health, but I feel concern about the outcomes of those paths and the very real dangers of lay persons, con artists and quacks misleading worried, desperate and sick Internet users.
Are There Positive Aspects of Dr. Google?
I can think of 3 of them.
1) If you’ve been given a diagnosis by a doctor who is too rushed to give you the consultation you deserve, using the web to research your condition can help you create a list of concise questions to come back to the doctor with on your next visit. You may read about alternative treatment options and brand new research that your doctor may not be aware of. The better informed you are about health problems you face, the more you are likely to be able to get out of your official visits with your medical provider.
2) If you suffer from a chronic ailment, the Internet is rich with support groups for a staggering number of conditions. Painful and long-term illnesses often go hand-in-hand with depression and it may be that joining an online chat room, message board or forum will help you connect with people around the world who really understand what you’re going through, in a way that your local loved ones simply don’t. I think support groups of this kind have real merit as a weapon against isolation and mental illness.
3) I’ve lost count of the number of people, particularly the number of women, I know who have exhausted their Western medicine options in dealing with chronic health matters. In such cases, the Internet can act as a research tool for alternative medicine. Because of the way we view health care in this country, non-Western approaches to health care tend to be viewed with suspicion by the ‘establishment’, and while there is some reasoning behind this, when a person cannot find the help they need from traditional approaches, they are certainly within their rights to seek it elsewhere. Google may be a useful tool in helping you learn about local herbalists, yoga classes, acupuncture options, pain management, etc.
I do think there is value in having medical information on the web, if it is used with wisdom and discretion.
The Safety Net
Matt McGee’s articles point out the danger of cyberchondria – the case of people becoming falsely convinced that they are suffering from illnesses they don’t actually have. I’ve made a point of referencing the serious hazards of lay persons misdiagnosing ailments. How concerned should we be about this fairly recent proliferation of user behavior forged by the existence of the web?
Moderately concerned, I’d say, and I’ll explain why. Because modern medicine is so deeply based in the giving of prescription drugs, most people will still need to go see a doctor in order to obtain this type of treatment. So long as Americans aren’t allowed to dose themselves with antibiotics and steroids, so long as they’ve got to go into a doctor’s office to get that little slip of paper signed before the pharmacist will provide serious drugs for them, I think most people who are in a position to see a doctor will continue to do so.
And those who can’t afford it are out of luck. That’s the unhappy bottom line. They may take over-the-counter medicines for complaints that deserve professional medical attention. They may turn to the web for faulty advice. The poor are alike in all countries. Remember that there are villages in third-world countries where antibiotics are still unknown and where people die every day for lack of simple medical care. With 50 Million uninsured Americans, our country contains a large population of people who are basically living as third-world citizens, in the midst of excessive riches. This is, of course, totally unacceptable and I’m holding Mr. Obama to his promise to change this dismal truth about our country, but in the meantime, for the destitute, perhaps the medical advice available on the web should be viewed as a potential benefit for those millions shut out of the insurance system. Perhaps it’s a case of some help being better than none at all. I’m not sure.
It’s a tough issue. A tough question. What do you think?