Ever since Dr Google and Dr Wiki set up shop in cyberspace, medical practice has become annoyingly complicated, complains every doctor I meet these days. More time is spent correcting misconceptions doing the popular media rounds than on providing scientifically-validated medical advice.
People read up everything they can on every little symptom they have, real or imagined, and take every possible online "symptom-checker" test and draw up a battery of potential diagnoses before fixing up an appointment with a doctor. By the time they land up at the doctor's clinic, I'm told, most googlers have decided what's wrong with them and begin the appointment by telling the doctor what the course of treatment should be.
They quote yoga gurus offering cures for chronic diseases, mountebanks peddling natural juices for life-threatening illnesses (papaya-leaf juice for dengue is no better or worse than any other juice), acquaintances and friends on cures they were told about by other acquaintances and friends, and increasingly, experts from Cleveland Clinic and Memorial Sloan Kettering for problems as simple as a stubbed toe (it could get infected and turn septic) and a runny nose (it could be an early sign of HIV that causes AIDS).
"A woman here last week spent 10 minutes trying to convince me that her allergic outbreak of hives was actually dengue. When I pointed out that she had no other dengue symptoms such as fever, she said it was a rare asymptomatic case of 'non-febrile infection' and went on to quote two journals that said more than half of all dengue cases do not produce symptoms," said a doctor. "I tried to tell her that if there were no symptoms, the illness did not need treatment, but all the stuff she had read had so muddled her mind that she refused to listen." After 10 minutes of arguing, he gave up and asked her to look for a doctor who would agree with her and not one who knew his job. "There's a lot of inaccurate and misleading information on the web. Diagnosis is a doctor's job and it should be left to us," he says.
He is right, of course, but a new study from the University College of London shows that people, who use the internet to look up their symptoms, read up about the latest treatments or research their disorder before meeting a doctor, gain more from the consultation than those who simply land up at a clinic. The findings, published in the British Journal of General Practice, showed that while some people felt doctors took them more seriously if they knew about the disease, others fretted that their doctor would get offended. Yet almost all of them mentioned information they had come by from other sources. Of these, googling basic information was the most effective way of opening up the conversation with the doctor and actually helped patients benefit more from the consultation.
It is not about undermining the authority of a doctor. For, irrespective of the truckloads of information unearthed from the internet, people still trust their doctor's opinion and need it to validate what they have read or experienced. Armed with wiki-info, they came to the doctor looking for his professional opinion and support without meaning to offend.
Appearing impatient or threatened indicates a lack of knowledge and unwillingness to learn, which is more likely to make the patient question the doctor's judgment than his simply attempting to address the patient's concerns. So, more than the patient, it is the doctor who has to walk the tightrope between engaging with the patient's concerns and firmly disregarding the web of misinformation acquired from popular media.
The best doctors are the ones who temper treatment with sympathy, for the ones that listen to the patient are the ones most likely to get the diagnosis right.