Do you find that access to the Internet with people being able to find out information more readily about ailments, makes your patients easier or harder to deal with?
Yes it does.
I’m a vet, not a medical doctor, but I’ll chip in, I imagine the same applies.
There’s good and bad information out there, as well as a lot of raving lunatics posing as experts. With no medical knowledge, it can be difficult for a layperson to know the difference. While some of our clients have found helpful information and even support groups to help manage their pets’ medical conditions, I’d say the benefits are far outweighed by the confusion caused by conflicting advice or information overload.
Examples:
Clients who google vague symptoms like lethargy or weight loss, then insist on expensive tests for some obscure condition despite it being an extremely unlikely diagnosis for their pet. Sometimes they invent or imagine additional symptoms to fit their home diagnosis.
Clients who have completely misunderstood what they’ve read - for instance, I had a client who was adamant that his particular dog breed can’t safely be anaesthetised, but it doesn’t matter because they can’t feel pain and therefore don’t need anaesthetics for surgery.
Not an MD, but I’ve been in a medically-related career long enough to see it happen where the patient Googles symptoms and comes up with an inappropriate impression and self-diagnosis. In other cases it’s hearing hoofbeats and assuming it’s a zebra, rather than a mundane, very common, well-known horse. One of my mantras is now “Horses. Horses. Not zebras.”
A recent problem has been that college-educated (middle class, in particular) people assume they know more than they really do, and didn’t learn or don’t remember how to think critically. One symptom out of 6 in a list matches, and by God, that’s what they’ve got and the doctor doesn’t know what they’re talking about cause that’s what this guy on the Internet said and my cousin’s friend had it and died… etc ad nauseum. I wouldn’t bet on a horse with a 1:6 odds, much less a zebra.
On the flip side though, this just happened to my boss w/ her Wheaten Terrier. About a month ago she’d gotten some minor symptoms (diarrhea mainly) and after some Googling she decided that her baby MUST have a condition called PLE (protein loss) that occurs in about 5% of that breed. “Pshaw…” I told her, “That’ rare and she just has some loose stools at the moment. She’s still eating and drinking fine, she’ll be fine.”
Turns out she did have PLE, and had to be put down this past Monday.
Depends , I find it both good and bad really. I find it healthy that no longer is medicine a black box.with this I mean you dont have to go to a library and dig up an old book to read about the essentials.
Information is in essence a good thing. People should have the tools to read up on the basics. That is a good thing. A dr shouldnt be some kind of mythical all knowing figure.
I do get pause and sometimes frustration from the newest flukes or internet sensations, the patients have read this and that about x and y, from dubious sources without knowing the process of evidence based medicine. Vaccination and antibiotics comes to mind, where ignorance seem to roam free and fed from pseudoscientific sites on the net.
But in the spirit of equality I wouldnt have it any other way. Sometimes though you are forced into the position of a debunkerer rather than a doctor.
Sometimes though watching TV makes me think we should be more careful letting celebrities like Jenny McCarthy/Maher et al preach their pseudoscientific agenda. Possibly with the potential to kill more people than the average 1900s dictator, but thats just during my bad days.
Yes, the free flow of information on the internet is wonderful, and at first glance a good thing. The problem is that all it takes is some pocket change to an ISP and one can disseminate anything without worrying about veracity. Many people don’t know how to fact check from multiple independent sources, and assume that the first thing they run into is The Truth. I am a pariah to my SIL because I challenged her social-site broadcasts by presenting supported, documented information from multiple sources that contradicted her information from HuffPo, AoA or circle-jerk webrings that created echo chambers.
Sometimes it can be helpful for people to go online to educate themselves, but in most cases I do think it just makes things more confusing and difficult.
For example, people will read about their medication and notice some horrifying 1 in a million side effect, and then they’ll be afraid to take the medication even though statistically it is far, far more dangerous to go untreated than to take the medication. There are numerous other situations where you can’t really put information in the right context unless you have some medical training and experience.
Unfortunately, most people in this country are very ignorant of science and medicine, so the spread of “medical knowledge” on the internet means the spread of a lot of misinformation and quackery too.
Not a doctor; I work in medical research in a hospital, at the point where the FDA approves a study of an experimental drug on a larger group of consenting (human) participants. I get a lot of people calling me up with questions about studies that they must have just caught some hype about and haven’t looked into in more detail. Top problems with that are:
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When they call about something and it’s apparent they’ve just latched onto a buzzword and not learned anything about what’s really going on. Most common one is people with all sorts of problems in this field, who are calling about wanting to be in our stem cell research. If you ask them about it, it’s obvious that’s all they know - that we’re doing stem cell research in our department. The only stem cell work my department is doing is in animals, and I know of no work in humans upcoming for years, at least. Plus the stem cell research that my department’s lab researchers are doing is very specific as to the disease and the aim, and people seem to think you can just sprinkle a few stem cells around and cure everything, because they’re calling about all sorts of problems.
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They call about a once-“hot” study which we haven’t done for years. Furthermore there are all kinds of ‘political’ and other issues tied up with that study (among other things, that it failed miserably), and people with the disease it was aimed at don’t have options. So it’s a tightrope walk trying to explain to people that it’s long over with and you know of nothing to help them.
The internet is great when you have a patient with a firm diagnosis, who is out there actively looking to educate themselves and get support, and has enough common sense to evaluate the sefulness and validity of various sites. Then you have an “expert patient” and they can bring a lot of good information and ideas to the consultation.
The internet is not good when you have people typing “causes of headache” into Google on a Saturday afternoon and diagnosing themselves with astrocytoma - and then coming to the EMERGENCY department on a weekend to demand a brain scan. Hello, non-drinker who only gets headaches at the weekend- when you drink five cups of coffee at work and only one at home, it isn’t a brain tumour, it’s your physical dependence on caffeine.
Why yes, this is a real-life anecdote, and it did seriously annoy me at the time.
The internet is not good when you diagnose someone with something that, in most cases, is benign and self limiting, but on very rare occasions causes serious complications. It is almost certain that the first website they find will be a worst-case scenario “raising awareness of how deadly this can be” type of site. Your patient will be unecessarily terrified and will lose trust in their doctor for not telling them how sick they “really are”.
The internet is not good when your patient has a crackpot theory that they want to prove- you can find a site somewhere that will agree with you on anything.
This is particularly the case with the Anti-Vaxers, but I have also seen it with a parent determined to continue breastfeeding her child despite the fact that he was not thriving and needed high calorie feeds that breastmilk alone (no matter how good quality or how much) could NEVER provide him.
Various material from far-out “boob nazi” type sites was use to justify her position that starvation on breastmilk alone was better than giving “posionous, unnatural chemicals” (i.e. calorie and vitamin supplements). Apparently she had support from a message board whose members were encouraging her to resist the “pseudo-professionals” trying to poison her child because they hate breastfeeding.:rolleyes: Yup, I hate brestfeeding so much I’ve been doing it for the past year.
I ain’t a doctor, but a patient, and this was exactly my experience. Several years ago, I was diagnosed with prostate cancer, and there were several treatments available: radiation, freezing, open surgery, robotic surgery, and just ignoring it (it’s very slow growing) were the main options. I talked to doctors who specialized in each treatment, and of course each doctor (naturally) thought his approach was the best. The guy who did open surgery pooh-poohed robotic surgery as “experimental” and “very risky.” The guy who did robotic surgery denied that and said it was the fastest recovery and best approach. The internet (various university hospitals) helped me decide that surgery was the best approach, and that robotic wasn’t “experimental.” There were comparative tables of success and recovery rates that allowed me to make an intelligent decision (robotic)… which I couldn’t have made from just talking to the doctors.
I struggle with this with a family member who reads a headline, and thinks that the information in the article is the last word on a subject. As much comfort as it might bring, science is never done finding the answer. It’s also hard to get people to understand the differences between and limitations of a pilot study, a small study (N < 200), large multi-center studies, 510(k) studies and Phase 0, 1, 2, and 3 studies and how the FDA figures into those.
Academia doesn’t help this, since they like to hold press conferences and show off what they’ve done with their R01 money. It raises their prestige in the community and region (if not nation), but curiously, one never hears the end of the tale when the study fails because the p values are > 0.05. The superstar studies are the ones supported with the most solid data, not the ones that get the most hype, but most people don’t understand that.
What Irishgirl said.
Overall, I’m glad my current patient population doesn’t have access to the internet.
The probably don’t do a lot of breastfeeding either.
I recently had to go to the emergency room for a broken bone, and the resident there even told me what to Google when I got home. I was writing stuff down as he was talking, so I guess he realized I’m a geek.
Later, when I had to see a specialist about the same bone, she did a serious eye-roll about patients having access to Google. Maybe she’s had more patients like irishgirl’s caffeine-deprived guy.
Really? none at all? Do the prisoners at your facility have email at least? I may have to give up my plans for a life of crime.
No email, no cell phones, no way of transmitting data out of the prison other than monitored snail mail and monitored phone calls.
A few inmates in certain jobs have access to an intranet system which is completely cut off from the outside, and completely cut off from other computer functions.
Otherwise, unauthorized use of any computer can buy the inmate time out in segregation status.
I’d not let lack of connectivity divert you from a life of crime, though. Inmates still have access, albeit illicit, to toilet hooch, prison tattoos, and both pre-emptive and retaliatory violence.
I’m not a doctor but as above, I am a patient.
I had some difficulty with my outside fingers getting painful and cramping during the night. My doctor said (correctly) it wasn’t a carpal problem and suggested it may be spasms and suggested magnesium tablets. I had sort of nailed it down to using a new laptop on a coffee table and after bit of search it came up with thoracic outlet syndrome. Change posture and it goes away (which it did).
So I think I was lucky there as it was a minor problem which had specific symptoms. It was useful for me as a GP can’t be expected to be aware of every thing out there. If he/ she said I was wrong and said something else of course I would take on board their advice.
[Momentary Hijack]
Sweet! How does one find a reputable tattoo artist in prison? Also, how do you figure out how to pair toilet hooch with the appropriate commissary snacks?
Not a doctor.
In my previous life as a Piano Technician, it seemed to me that the best clients were those who knew a little bit about how pianos work. The worst clients were those who knew just a little bit more.
Because they didn’t realize how very much they still didn’t know.
Sorry if this 2¢ isn’t relevant to the conversation.
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