There’s a joke that we tell in my family to irritate my physician father.
A doctor dies and goes to heaven. When he arrives at the Pearly Gates in his scrubs, he strides up to the front of the line and demands to be let in because he, a doctor, clearly deserves special treatment. After all, he’s been through medical school. He can save lives. He is, in short, awesome. St Peter tells him no and sends him to the back of the line.
Moments later, another dead guy, also wearing surgical scrubs, walks to the front and the gates swing open for him. The first doctor asks why he let the other one in and not him. St Peter responds: “Oh, that’s God. He thinks he’s a doctor.”
Illustration: mountain people
It is a terrible generalization, but doctors have historically tended to think that they have all the answers. And when it comes to matters of the heart, lungs, liver, pancreas and other cuts of the human corpus, they certainly know more than the average person.
However, a public increasingly informed about medical options and personal well-being is beginning to question the medicine man’s authority, thanks to the trove of health-related content online. Anything you want to know about any symptom is not only available in triplicate (often with conflicting advice), but that information is often accompanied by prognoses, treatments and social support networks. You can now effectively bypass the doctor’s surgery completely by self-diagnosing and self--medicating. The Web is having a profound effect on how we understand and how we do health.
Last week, the healthcare company Bupa and the London School of Economics released the results of an international healthcare survey. More than 12,000 people across 12 different countries were asked about their attitudes towards aging, chronic diseases and health and well-being.
The report, Health Pulse 2010, made headlines around the world, not just because it coincided with people kickstarting the new year by logging on to fitness Web sites or checking their flu symptoms, but also because it fed our concerns about the Web: It condemned online health -information and us for believing in it.
To summarize their findings: More of us than ever are using the Web to find out more about an ailment before or instead of visiting the doctor. More health-related Web sites, tools and social networks are available to support this demand. And, most alarmingly, only a quarter of the people surveyed checked the reliability of health information they found online by looking at the credibility of the source. In other words, a typical medical consultation now follows this trajectory: 1) you discover a growth, 2) do a Google search, 3) believe the first result that confirms your expectations.
One specific mistake that people now make when searching online also strikes medical students around their second year, when they’re starting to get into the nitty-gritty of pathologies. I suffered a version of this so-called Medical Student Syndrome when I was taking my psychopathology courses: Looking at all the symptoms of all the mental disorders listed in the American Psychiatric Association’s diagnostic bible, the Diagnostic and Statistical Manual of Mental Disorders-IV, it was clear that not only was I paranoid schizophrenic, but all of my close friends and family most certainly had post-traumatic stress disorder, obsessive-compulsive disorder, borderline -personality disorder or Munchausen’s syndrome.
Anyone with an interest in their health 20 years ago could have gone to a library and diagnosed their illness incorrectly with the help of research journals, but nowadays a search engine will deliver exactly what’s wrong in a nice printable format. Social networks and forums will add more confirmation and offer support, as well as offer examples of new tics and symptoms that you may not have realized were part of your problem. Armed with false certainty and more than a spoonful of paranoia, you march to your medical practitioner and demand treatment.
As this new medical informatics trend began bubbling in the early days of the Web, sociologists and medical professionals predicted that a new relationship between patient and practitioner would develop. The paternalistic approach taken by doctors — you have X ailment and you can only fix it if you follow my advice — would evolve into a partnership in which they would facilitate a patient’s recovery rather than prescribe it. This puts docs in a funny new situation: They must now incorporate persuasive techniques to convince patients that they offer the best counsel. In the past, we’d have simply swallowed any pill, however bitter.
The health and well-being industry has evolved to address this relationship. For patients and their families who want more information on treatments they’ve been prescribed, information from credible sources provides peace of mind as an illness progresses. Evidence from almost a decade of research in journals such as the BMJ, Health Education Research and the Sociology of Health & Illness argues that having a very specific query results in the most valuable online health information.
However, we can pay a serious price for our newfound medical insight: Web sites will help identify what’s wrong and give you a treatment schedule if you submit details about your age, gender, blood pressure, exercise regime, family history and dietary habits. How should we maintain our autonomy over the often very sensitive information that we put into diagnostic sites? It’s stored somewhere and used somehow, and we have no idea what will happen to that information in the future.
There is no doubt that the wealth of health information online has contributed to a more informed public, but this is an area in which I believe the expertise of the professional should not be undermined by the leveling power of the Web. As dad says, doctors who treat themselves are fools. Even if those doctors aren’t infallible, they have a hell of a lot more experience in saving lives than you or I do.
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