The following is a guest post by Carolyn Thomas, a heart attack survivor and e-patient who excellent blogs talks about her experiences and lessons learned at Heart Sisters.
Me: “My name is Carolyn, and I’m a Medical Googler.”
You, all together now: “Hello Carolyn!”
This will come as no surprise to any of you regular readers, but I’m just a wee bit obsessed about All Things Cardiac. From the minute I was sent home from hospital last May following my heart attack, I started mainlining Google like it was a drug, and I became hooked. I threw myself into researching women’s heart disease in a determined attempt to figure out what the heck had just hit me. And after I had the opportunity to spend five days at Mayo Clinic in October, I became truly insufferable.
That’s how I happened to learn about the WomenHeart Science & Leadership Symposium for Women with Heart Disease at Mayo Clinic last fall: I found it on Google. That’s how I found hundreds of other Heart Sisters – all survivors like me – on the National Coalition for Women With Heart Disease WomenHeart online support community. I found them on Google. And that’s how I began subscribing to regular cardiology news bulletins from medical journals, clinical research sites, and university heart institutes. I found them all on Google.
And that is also how I came to inform my cardiologist last month during my regular follow-up visit that doctors should no longer be prescribing the drugs Plavix and Wellbutrin together anymore, because, yes, I’d found the FDA Drug Alert on Google. But he told me that he had not yet heard about this Drug Alert – one full week after the warning had been issued.
I am, apparently, a doctor’s worse nightmare now.
Dr. Stuart Foxman of the College of Physicians and Surgeons of Ontario implied as much in his blog for physicians called DocTalk. He wrote about the growing phenomenon of patients who are now self-educated Medical Googlers. One study found that many physicians rate the know-it-all Googler as somewhere between “frustrating” and “irritating”.
The study noted a number of doctors’ concerns. Some patients used the information gleaned on their own for self-diagnosis or self-treatment. Some doctors believed that the information caused the patient unnecessary confusion and distress. “All of these seem like legitimate concerns on the part of physicians,” explains Dr. Foxman.
But he notes that the doctors surveyed in this study expressed other concerns, too.
“The highly curious and informed patients were sometimes perceived as ‘challenging’ with a tendency to test the knowledge of physicians. Some doctors felt that these patients were overly assertive, undermined their authority, and did not show sufficient trust in their health care provider.”
Dr. Scott Haig‘s Time magazine essay called ‘When The Patient Is A Googler’ is a scathingly arrogant attack, describing his Googling patients as “suspicious and distrustful, their pressured sentences bursting with misused, mispronounced words and half-baked ideas.”
Just a tad oversensitive to having his authority undermined, perhaps?
Dr. Haig writes:
“Some patients don’t want to know what’s wrong with them, what medicines they’re taking, or even what kind of operation you’re planning to do on them. ‘Just get me better, Doc,’ is all they say.”
Now there’s a nice, compliant, well-behaved kind of patient who would never even dream of undermining Dr. Haig’s authority by trying to learn about their medical condition and then coming up with all those half-baked ideas.
Attention Dr. Haig, and others of your ilk: if enough women continue to have their symptoms dismissed or minimized or – worse! – misdiagnosed (as I did when the ER doc told me I was just having acid reflux instead of a heart attack), then you can expect more and more of your patients to start doing their own Googling research in an effort to educate themselves as much as possible about what is happening to their own bodies.
The clear reality is that the volume of medical, health and wellness material that is readily available out there, and the number of people who regularly access it, are both increasing, whether Dr. Haig likes it or not.
The website WebMD alone gets over 40 million visits every month. Up to 80% of internet users have sought medical information online. And a reported two-thirds of patients apparently want their doctors to recommend reliable website resources for them.
Dr. Foxman adds that there are, of course, ‘cyberchondriacs’ who believe that whatever condition they’ve read about on the internet must be the horrible ailment they have. And the amount of sheer unadulterated trash online is mind-boggling. That’s why Dr. Foxman recommends reputable patient resource sites like the Public Health Agency of Canada.
Medical Googling is not only for those patients who want to sincerely learn and ask questions about their own health, but online searches can also be a diagnostic tool for physicians. Australian researchers reported in the British Medical Journal on their study that chose 3-5 search terms for hard-to-diagnose illnesses, and then looked at how Google did compared with reports published in the New England Journal of Medicine. The study found that doctors who use Google to help diagnose difficult cases can find a correct diagnosis over 60% of the time.
I now wish that the ER doc who sent me home in mid-heart attack with an acid reflux misdiagnosis had instead tried Googling my symptoms (crushing chest pain, nausea, sweating and pain radiating down my left arm). I’m now fairly confident that Google would have steered him to the correct diagnosis of myocardial infarction!
The British Medical Journal also notes that doctors have been estimated to carry an astonishing two million facts in their heads to help them diagnose illness – but Google gives them quick access to more than three billion medical articles.
Who can keep up with three billion medical articles?
I like to think that I was really just helping out my wonderful cardiologist by passing on to him what I’d Googled about that FDA Drug Alert.