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‘I shouldn’t have done it, doctor,’ says Ms Robinson. ‘But I just couldn’t help myself. I know you aren’t meant to.’
She has that same guilty half-smile that patients have when admitting to drinking 70 units a week, or last taking exercise in 1996. It’s been suggested that in modern society doctors have taken on the roles of priests, and sometimes it does feel as though one of the things patients seek from us is absolution.
But what can Ms Robinson be about to confess? She looks a clean-living type, healthy BMI, certainly a non-smoker, and as far as I know not a rabid anti-vaccinationist. What is it she feels she needs to apologise for?
‘I knew you wouldn’t want me to, but I googled it.’ And she sits backs, braced for my reproach.
However did we get into this situation? If the medical profession publicly declared it wished to discourage patients from informing themselves about their illnesses, we’d be rightly condemned as crazed paternalists, yet most people seem to believe their doctor will be mortally offended if they read up on their own condition. The internet, used with a little discretion, is a treasure trove of information, self-management advice and encouragement from fellow-sufferers.
Okay, maybe that ‘used with a little discretion’ is quite a caveat. You needn’t spend long reading the comments under any online article to realise that discretion is not the defining characteristic of everyone on the internet. And it certainly is a little trying to be presented with fourteen pages of nonsense printed off the web and expected to peruse it mid-consultation, or to be asked to provide a detailed critique of some snake-oil merchant’s dubious claims on the spur of the moment.
More seriously, the internet can be a scary place. Dramatic diseases attract more clicks, and if you image-search even a fairly benign condition – say ‘eczema’ – you get some startling pictures. (I advise you not to try this with ‘Stevens-Johnson’, at least not while eating.) And any given symptom will link to dozens of horrific potential diagnoses, the actual likelihood of which many patients may be unable to judge.
Granting all that, people taking responsibility for their own health and seeking to inform themselves is something we should welcome. Forbidding health-related internet use would be throwing out a valuable baby along with some admittedly pretty scummy bathwater. We should reassure Ms Robinson, ask her what she found, and talk through the questions it raises. When Dr Google’s input irritates me, I try to picture him as a tactless and slightly erratic but zealous junior colleague. We need to moderate his advice, but trying to get him struck off is not the way forward.
By the Secret Doctor
Read the blog and follow @TheSecretDr on Twitter and on Facebook
I welcome google but suggest evidence based sources e.g. Patient uk and NHS choices.
How did you know that Dr Google is a male? I didn’t know the internet search engine had a gender assigned to it.
Whatever you tell them, they are going to do it anyway. The best thing I do is assess their condition and give my opinion. I also give them a credible source of information on the www for them to read at leisure. So they don't have to troll through a vast amount of information Dr. Google throw at them.
In the future, we will all be using differential diagnosis generators. This is a good thing as it is very easy to forget rare - but treatable - conditions which we do not often see in day-to day practice. Dr Isabel will see you now!
Good that you have raised this topic Dr Secret. For some years now I have been aware of the fact that Information Professionals ( otherwise known as LIBRARIANS) consider themselves to be "health professionals too" - New Vice President to 'honour the past and look to the future' - CILIP ...
8 Nov 2017 - CILIP Vice-President VP David-Stewart Board Election Health .... You cannot have a profession without a professional body and all the ethics, ...
With the forthcoming "review of the Universal Health Offer currently available in every Public Library " to be conducted by the new charity "Libraries Connected"
Libraries Connected |
it would be very good if you , Dr Secret , became fully engaged in the planned review so that patients and carers can be offered "guided web surfing" by Health Professionals in spaces and places created as "environments for learning" in Public Libraries . This is an aspect of Health Service provision that was not considered as being at all important when the NHS was set up. . Dr Malcolm Rigler www.librariesandhealth.com
"It's up to you Mrs Robinson..." surely
Wise words and eloquently put thank you
There is a big difference between a diagnostic search(googling your symptoms),and learning about your diagnosed illness.The latter is informative,the former merely an anxiety provoking exercise.
I do think every patient has to take responsibility
As a doctor being non judgemental and providing information to our patients is paramount
I give them information leaflets With websites recommended It is their informed decision
I would not recommend every website. But also they have a choice to make This is very relevant to my speciality
Yes most of them come to us feeling awful n that they would be judged
They do not always seek absolution but seek our opinion .
Empathy is of utmost priority
In simple terms enable them with information that is appropriate n they can make an informed decision
I do not profess to know everything that’s on the internet but I can understand a patient trying to gather information in the best possible way they know . Wouldn’t you if you had no medical knowledge ????
I agree that in this day and age it is utterly futile to expect patients not to research their symptoms/diagnoses online. The way forward must be to try to steer them towards reputable websites giving sensible information and advice, while gently pointing out that much of the health-related content on the internet is alarmist or just plain wrong.
There are some great internet sources for information and support with a wide range of health conditions - you just have to be aware of quality control issues and help people to distinguish good sources from less good, or downright bad. One way is via NHS England's accreditation scheme for health and social care information - the Information Standard. Take a look at healthtalk for example which is a shining example of excellent information: www.healthtalk.org/.../health-care-information-you-can-trust