Googling Symptoms Helps Patients and Doctors

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The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is here with a pile of Internet printouts listing all the crazy things she thinks she might have.”

The intern continued, “I think she has a hemorrhoid.”

“Another case of cyberchondria,” added the nurse behind me.

In the end, the patient did, indeed, have a hemorrhoid. She was safe to go home with a treatment plan and some reassurance. But I wasn’t so sure if what doctors call the “Google stack” (the printouts listing all the potential and worrisome diagnoses) was really such a problem. After all, her symptoms were scary — she may very well have come to the ER regardless of her Web search. The real problem was with my team: we weren’t well equipped to deal with her online homework — and it became a distraction.

Whether the Internet is a useful or dangerous place to get health information is not a novel question. Information overload, biased sources, complicated jargon, conflicting recommendations and stories that always seem to invoke nightmare scenarios are well-known reasons to be wary of Googling your symptoms.

Yet there is no question that patients routinely benefit from going online before visiting the doctor. Recently I saw a patient who came to the ER with a strange rash. She arrived with color printouts that correctly identified her condition. Not only was she correct in her self-diagnosis, but I am not sure I would have considered the right diagnosis so quickly if she hadn’t brought in the pictures (it was a common condition with an atypical presentation). I know many health providers who have experienced similar circumstances.

But to debate whether patients should or should not Google their symptoms (which a surprising number of doctors seem to enjoy engaging in) is an absurd exercise. Patients already are doing it, it is now a fact of normal patient behavior, and it will only increase as Internet technology becomes ever more ubiquitous. The average Joe has more health information at his fingertips — both credible and charlatan — than all the medical libraries ever built put together. So the real question is, What can professionals do to translate this phenomenon into better health for their patients and the public?

First, they can adopt strategies in health-care delivery and education that endorse the process of patient self-education. Shared clinical decisionmaking is an influential model for patient care now being promoted by researchers, educators and the federal government as a way to get patients to partner with their doctors to take an active role in making decisions about health care. The ideas behind this model were outlined in the late 1990s by researchers at McMaster University in Ontario, Canada, and were important enough to be included in the language of both the federal stimulus and health-reform laws. This model recognizes that many choices in medical care often involve complicated trade-offs. In this process, patients are encouraged to become informed of the nuances related to a health-care decision in advance of the doctor-patient encounter; and the Internet has naturally become the place where these tools can be found in the form of worksheets, videos and decision aids.
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