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Health Experts versus the Internet

Visalia Direct: Virtual Valley
May 2008 Issue
April 11, 2008

Health Experts versus the Internet

“I read on the Internet that the real cause of….”

When the research physician started her presentation with that familiar refrain, the room echoed with muffled laughter.

During the two years I have been conducting research on special education methods, I have come to appreciate the difficulties that must confront many doctors, nurses, and physical therapists, and psychiatrists. It seems one of the greatest challenges facing health experts is the Internet.

Before you assume I am suggesting the experts should be the guardians of all knowledge, understand that I like having information before I meet with doctors, too. I hope I use the information to ask good questions, not to diagnose myself when I’m not well.

Alan Gross, author of The Rhetoric of Science, told me that doctors increasingly give in to patient demands because patients can and will find doctors willing to prescribe the latest medications. Gross said the Internet has made matters much worse than ads on television. “Informational sites” created by drug companies contribute to this atmosphere.

The parents of special needs students want their children to be given every opportunity possible. In some cases, medications promise to help with concentration, seizure disorders, digestive problems, and more. Who wouldn’t want better for a child?

A parent told me she had “suggested” nearly every medication her child had tried. “The pediatricians didn’t know enough about any of them.” Yes, she had engaged, proudly, in “doctor shopping” based on information from the Internet.

“If a doctor isn’t going to treat my child, I’ll find another doctor and another after that.”

I don’t doubt that the same patterns occurred before the Internet was popular, but the Internet has definitely changed the amount of information, right or wrong, that parents have in hand. This abundance of information, not to be confused with knowledge, is leading some of us to second guess health care providers. As a result, some doctors do prescribe what adult patients or the parents of children demand.

Gross asked me to consider the parent with a stack of printouts from the Web on various ADHD medications. “It would take hours to discuss every page with the parent.”

It doesn’t matter what the condition, a patient or guardian can and will seek out information. The problem is that we don’t always know how trustworthy the stories and data we find might be. We need to be more discriminating.

I happen to like WebMD as a source for basic information. I tend to check the potential side effects of medications and any interactions that might be less than pleasant. Probably like most WebMD visitors, I imagine a doctor, nurse, or pharmacist has verified all the information I read.

But, since I am not a doctor, I have no idea how likely actual drug interactions are. The site might list a “potential” side effect that is about as common as winning the lottery. I’d never know the difference between a common and a rare side effect.

Because WebMD is a business, there are features to encourage repeat visits. Message boards, columns, and even a “Top 12 Health Topics” feature vie for your attention. The message boards are of particular interest to me. Researchers have found that people are more likely to believe personal stories online than medical experts. We apparently believe a stranger’s story on a Web site more than dry medical statistics.

Exchanging stories online is easy, while verifying them is nearly impossible. Statistics just don’t pull at our hearts in the same way as stories. I’ve witnessed this affect when speaking to parent groups. Parents have told me they’ve read about the medical horror stories about flu vaccines, eating tuna, wheat gluten, swimming in lakes, and more. The Internet gives us a lot of reasons to be afraid, if we want to be.

The feature of WebMD that most intrigues and disturbs me is the “Symptom Checker.” Answer a series of questions and WebMD will match your symptoms to a list of potential medical causes. A user can spend endless hours discovering various maladies. Doctors are forced to compete with a database potentially tailored to hypochondriacs.

The non-profit Mayo Clinic (mayoclinic.com) offers a similar feature, also called “Symptom Checker.” Apparently, there is a lot of interest in computer-based diagnostics. All we need is a virtual Dr. Gregory House to tell us why the initial diagnoses are always wrong.

The Mayo Clinic doesn’t have open forums or mass media headlines to panic visitors. Though it can be technical, I have looked up specific conditions on the site. Researchers and staff at the three Mayo Clinics prepare the information on the Mayo Clinic site, which explains the technical style.

If most of us relied on the Mayo Clinic and WebMD, things might be slightly less complex for doctors. Of course, the Internet encourages random searches and following links on impulse.

A long list of Web sites, which are among the top search results on Google and Yahoo, are dedicated to the “medical conspiracy” against Americans. Many of these Web sites embed the word “truth” in their domain name. These sites appear to be the work of serious researchers and physicians, though that’s rarely the case.

Because these Web sites look professional and offer convincing stories, people do believe their content. Popular conspiracy theories might be leading to health risks, and are definitely leading to confusion and fear.

The Centers for Disease Control and the National Institutes of Health have been involved in scandals, which only add to the legitimacy of conspiracy Web sites. Famous journals have printed falsified studies in the past. Some tough lessons have been learned.

Medical science has also come a very long way in the last quarter century. But, the conspiracy Web sites know that pointing to the past makes anything seem possible. Doctors are forced to defend themselves against a “Web of intrigue” (pun intended).

We aren’t going to stop using the Internet to check medications, potential diagnoses, or other medical information. What we, as medical consumers, need to realize is that doctors do care about patients. Instead of going to a doctor with reams of printouts and a self-diagnosis, consider a list of questions.
I’ve learned doctors don’t have all the answers. They also don’t mind informed questions. Discussing matters, you might learn the online information isn’t always complete.

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