HYANNIS – When you have a new pain, rash, or unexplained symptom, are you more likely to visit ‘Dr. Google’ or your own physician?
Chances are, you will consult the internet before calling your doctor, even though your instincts may tell you that self-diagnosis isn’t very safe.
“Dr. Google is not the authority; your doctor is,” said Michelle Costa, DO, a rheumatologist with Cape Cod Rheumatology Center in Falmouth.
Google has disclosed that about one in 20 searches are for health information.
In recognition of the fact that many of her patients research their conditions on the internet before an appointment, Dr Costa said she has adapted the way she practices medicine to incorporate patients’ internet habits. She encourages her patients to write down any questions they might have from their own research and bring them to their appointments.
“I deal with Dr. Google every day and I am concerned about two things that affect patients: misinformation and negative bias on the internet,” she said.
The most famous example of how dangerous the internet can be is the publication by Dr. Andrew Wakefield of a study later proven fraudulent linking autism and vaccines, she said. That one paper generated fear internationally and led to a tendency among many parents world-wide to withhold life-saving vaccinations from their children, said Dr. Costa.
The only thing worse than inaccurate information is web content peppered with negative bias, which Dr. Costa said occurs when a few angry, unhappy people make more noise than the majority.
“People tend to go online to complain about a medication when they have had a negative outcome, yet all the people who have had good outcomes don’t rush online and say how fabulous the medicine was,” she said. “That’s one example of how negative bias begins to dominate and overtake the accuracy of online information.”
Consider the Source
While the internet is not always a healthy place to find your information, Dr. Costa said it’s not all bad.
“I love websites created by professional organizations like the American College of Rheumatology,” she said. “They publish guidelines for treating certain diseases, and you can go to those websites and read information that reinforces your doctor’s advice. With standard-of-care medicine, there are online resources to help you better understand your condition as well as what your doctor is recommending and why.”
Dr. Costa also loves online resources, like the website of the Arthritis Foundation, Arthritis.org. Online support groups can also be helpful, she said. There may not be a support group for you on the Cape, so she believes that online groups can be helpful and comforting, especially when you have a chronic diagnosis.
“I wish I could spend more time with patients so we could chat a long time about their illnesses, but that’s just not possible in medicine today,” she said. “So, I recommend quality websites where patients can learn more and even interact with others who share the same concerns.”
The internet has replaced the photocopied literature we once handed out about illnesses, and that’s a good thing, she noted.
Tips for Smart Internet Use
In addition to checking with your doctor for reliable websites, Dr. Costa has these suggestions to make the internet work for you.
Be aware of ‘cyberchondria.’ Don’t let the internet lure you into unnecessary anxiety about diseases you’re seeing online. Like hypochondria, an excessive preoccupation with one’s health, cyberchondria is unfounded anxiety about the state of one’s health brought on by visiting medical websites.“It’s a well-known phenomenon in medical school that first year med students have medical student syndrome,” said Dr. Costa. “When we start learning about diseases, we’re convinced we have them. It’s easy for cyberchondriacs to fall into that trap.
Be very careful about misinterpreting data on the internet, unless you know how to analyze it. “I’ll give you a perfect example,” she said. “A few years ago, a study was released that got instant news coverage about how taking calcium supplements could increase your risk of cardiovascular disease. But when you tore that study apart, it didn’t apply to people with osteoporosis, it applied to people with chronic renal failure.”
Watch out for dated information. “When patients bring articles to the office, if they are a few years old, they are out of date. If you’re reading a book on anything medical, it’s most likely out of date because the science of medicine changes so rapidly,” she said.
When you’re looking for medical advice, chose websites that end in .org (because they tend to be nonprofits) and that aren’t trying to sell you something. “Ask yourself ‘Who is funding the website?’ If you’re looking for nutritional advice and the website is trying to sell you supplements, then that’s not a place you want to trust for medical information. Finding out who is funding the website can give you a clue as to potential bias,” she said.
If you’re looking in the right places, the internet is a great resource, just as long as you don’t let Dr. Google become your primary care physician, said Dr. Costa.
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