| Monday, January 01, 0001
Healthy Skepticism: Helping Patients Help Themselves Online
These days, virtually any brick and mortar service has its own internet doppleganger. One can attain a college degree by attending online classes, stream movies directly from the source and of course, there’s Wikipedia, the online staple that’s put the final nail in the coffin of the door-to-door Encyclopedia industry. And while there’s seemingly no end to the wealth of information afforded to us on the internet, that information does come at a price: internet “quality control” is spotty at best.
Now, that’s well and good, likely entry level information to anyone who’s ever written a term paper or sought out unbiased information in a Honda forum...but then again, internet literacy isn’t always a straightforward metric. In a recent article by Tanya Fenke MD, (Dr. Google Should Be Sued for Malpractice. Here’s Why), the author illustrates the inherent problem of taking all of our health concerns to Google, namely that internet sources quickly become outdated, are biased towards their benefactors and constituents, aren’t often written by healthcare professionals and often lack traceable references. In fact, as the title dictates, she suggests that if Google were a physician, he or she should be sued for malpractice, based on the number of problems that disseminating false information causes (no word on Dr. Pepper and Dr. Feelgood’s prospects at the time of publication).
While I wholeheartedly agree with Fenke’s assessment, that Google, or an internet search, isn’t a sustainable replacement for actual medical advice from an actual, living, breathing medical professional, I also realize the dilemma of Google’s involvement in everything. The trends of internet ubiquity aren’t going to slow, nor will Google’s lumbering ascent into total control of the internet cease. This isn’t glass half-empty philosophizing either, just the acceptance that if/when (more like when) the machines finally do take over, we can assume Google will be in the mix somewhere.
Instead, it’s becoming important for physicians to not only be the conduits towards viable health information, but also to help patients establish good searching habits for when they come across health information on their own time. Physicians cannot dictate what their patients will read and see outside of the office, but by giving them the tools to sniff out what’s good and what probably needs a second opinion; they greatly reduce the number of faulty accidents and misunderstandings.
Look for Recent Content
Health information is subject to ongoing developments and research, on micro and macro scales. What was once the de-rigueur health fad or yesterday might have been proven total bunk today, and vice versa. In that regard, information on the internet can run a little bit dicey since (theoretically) anything put online stays online forever. Encourage patients to check their sources and to be wary of any sources from more than a few years old, particularly if it’s dispensing health advice. Even if the information has stayed the same, credible and reputable outlets will be sure to keep things current anyway.
Additionally, the idea of timeliness opens up the discussion for physician blogging and social media, a great way to create relevant and reputable content quickly, to update on information that is changing and to just generally maintain a current channel of communication. Patients should also be wary of information that doesn’t contain any dates as there’s no way to determine how recently it was obtained and published.
Objectivity and Bias
It can be difficult to look objectively at one’s own symptoms, especially when emotions are running strong and influencing one’s actions. In this regard, internet searching along various strings of keywords can push the user towards a “self-diagnosis” that is biased or at the very least a little skewed. This also introduces what I call the “WebMD” effect in which a person goes down the internet rabbit-hole of reading all symptoms associated with a certain disorder and slowly convinces themselves that they indeed have the disorder. No one is immune to momentary flashes of anxious grandiosity.
Furthermore, there’s a wealth of “for profit” sources out there, posing as viable health professionals, even when they’re not. Wary patients should be mindful of any sites with corporate sponsors, as the information contained may just be a sideways plug to get you to buy a miracle product or to sell you on an affliction you don’t actually have. Solid health information is a right, and shouldn’t market you towards buying anything new.
Experience and Credibility
It goes without saying, but a number of those dispensing health care information are just writers….not doctors (this one included). In this regard, knowing exactly where a source comes from can be what will set off the “nonsense meter” right away. Patients should look for the credentials of an author who’s dispensing health care information, ensuring that they’re actual, medically licensed doctors. Even so, it’s not uncommon for professionals to get their articles ghost written by off-site writers. Patients should assume that any information coming from a source that doesn’t identify as a physician should probably not be regarded at all, and those that come from doctors, should be carefully vetted before following up on them.
Sources and Citations
In print, most must cite their sources, but on the internet, and it can be a bit more difficult to truly regulate this principle. If a site doesn’t cite the sources of its claims, or if they’re especially absolute or broad and sweeping, one should maintain their skeptic senses a bit. Information can be sensationalized to drive ratings and page views to a site, and often take claims and facts out of context, specifically to fit their own content agenda. If a site doesn’t provide sources for its health care advice, isn’t from a health sanctioned organization or contains many sources from less credible sources, patients shouldn’t accept the information sight unseen. Remember, if a site doesn’t want readers to know where they got their stories, at best they likely don’t have anyone’s best interests in mind and at worst, could be hiding something.
Encourage the In-Person Follow Up
Fortunately, physicians still have the ultimate, and most credible, say in directing patients towards quality health care information. Besides endowing them with a dose of healthy skepticism towards online health information (and let’s be honest, it’s a good trait to have in an election year too), it’s important to remind them that they can always follow up directly with you, a primary health care source, about anything unclear. Not only does this type of outreach send the message that you’re there to help and guide them in their healthcare journey, but also establishes a precedent for always checking up with a qualified source before taking anything to heart.
Ultimately, we shouldn’t recognize Google as anything even remotely like a doctor and should recast it for what it really is: “a huge repository of information, scrupulously indexed and largely unregulated.” Patients and users still have the power.
Feke, Tanya, MD. "Dr. Google Should Be Sued for Malpractice. Here's Why."
KevinMD.com. KevinMD, 09 Aug. 2015. Web. 17 Aug. 2015.
Johns Hopkins Medicine Health Library. "Finding Reliable Health Information Online."
Hopkinsmedicine.org. Johns Hopkins, n.d. Web. 17 Aug. 2015.