Doctors despair as patients present with internet-derived diagnoses

Doctors found it irritating to have to cope with patients who arrive in their rooms with self-diagnoses derived from time spent googling, writes Terry Prone

Doctors despair as patients present with internet-derived diagnoses

A few years ago, I chaired a medical conference for hospital consultants in Vienna. One fascinating paper followed another, each received with nods, note-taking, and a few questions when the speaker reached the end of their allotted time.

But a palpable shift in attention happened when some research was presented about frustrations consultants experienced on the job. Top of the list was Dr Google. The speaker enlarged on how irritating it is for doctors to have to cope with patients who arrive in their rooms with self-diagnoses derived from time spent googling.

As he did so, the conference room’s tiers began to fill up with doctors who had,presumably, been off having coffee or a glass of plonk. Others made room for them, making “wait till you hear this” grimaces.

Auditors began to lean forward across the back of the seats in front.

What was apparent, even before the specialists began to ask questions, was that the paper literally provided one for everybody in the audience: The research had outed a major annoyance and each individual felt vindicated in their — up to now — private resentments.

When the question and answer session opened, it quickly became clear that nary a query was going to be put to the speaker, and me interrupting an impassioned monologue with the severe direction — “your question, please?” — was a complete waste of time.

Virtually every one of those present wanted to rant. One after another, they made speeches, told stories, vented their anger.

If someone could close down Dr Google, they said, life would be perfect and relationships with patients pure joy.

As it was, they had people coming into them convinced they were dying when they had a minor or imagined ailment, or demanding a drug that would cause them enormous problems.

What drove them nuts altogether was when patients arrived waving printouts of information they had gleaned from Dr Google and expected their doctor to read this drivel in the middle of a consultation.

None of the medics was afraid that they would be supplanted by Dr Google.

Their rage was engendered by the practice of their patients of consulting Dr Google before they came and paid for a real, live consultation.

It was the reverse of what has happened in retail in recent years, where shoppers go into a department store to have a look at jackets and then go home to purchase online the one they liked in the shop.

The doctors weren’t losing any money as a result of Dr Google, they were just losing their minds. Which, in fairness, can be a problem.

Shortly thereafter, along came Dr Andrew Wakefield and his misbegotten theories about autism, which undoubtedly resulted in the deaths of children because social media followers decided he was possessed of a truth mainstream medics wanted to hide from the public.

For some reason, this trope of doctors not wanting their patients to know about a method of prevention or cure that often requires little more than bleach, vinegar and a large helping of overconfident gullibility is a continuing success on social media.

It speaks to our ambivalent relationship with the medical profession that so many people buy this line, and it’s yet another contributor to the bucket of irritations most doctors group under Dr Google.

But it also speaks to the arguably essential human need to be in charge of one’s own health. Long before the internet, indeed more than 100 a hundred years ago, Jerome K Jerome’s novel, Three Men in a Boat, was wildly popular and has stayed in print.

When one of the characters is feeling poorly, his doctor gives him a prescription which he takes to the local pharmacy, who considers it gravely before turning it around so the patient can read what it says:

“1 lb beefsteak, with 1 pt bitter beer every 6 hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff up your head with things you don’t understand.”

Jerome K Jerome’s doctor was the precursor of the current anti-Dr Google generation, with whom one has to sympathise.

Up to a point. But what good doctor is so professionally insecure that they actively want their patients to turn up sick and ignorant? What good doctor disregards the lived experience of a body owned by the human who’s been walking around in that body for 40, 50 or more years and relies, instead, on a pencil-case of blood vials sent off to a lab for testing?

Could we timorously suggest a level of disengagement, not to say patronage, in those doctors who find knowledgable patients repellently exigent? And while we’re on the issue of being patronised, how about the story told by Alastair Cooke, the US-based British-born journalist, who was having mobility problems and wash ospitalised as a result.

Because Cooke was used to asking questions, he sought from the orthopaedic consultant a cause for the leg turning bad.

“Ah, well,” the consultant said, smiling indulgently and patting the affected limb through the bedclothes, “you must remember, Mr Cooke, that this is a 90-year-old leg.”

“True,” came Cooke’s crisp response. “But the other leg is 90 also, and it’s doing fine.”

That incident happened before Dr Google became a force, but it does indicate a desire on the part of the orthopod that his patients take his word as gospel, do what they’re told, and maintain a level of ignorance only to be lifted, like the corner of a tent, when the consultant chooses to enlighten. (The consultants who choose to enlighten tend to be the ones who like drawing pictures to explain to the sufferer what the sufferer already understands.)

We love when consumers in other areas of life go to the trouble to gain some basic knowledge of our field. It prevents them applauding between the movements of a symphony, for one thing, leaning heavily on the electrified fence at the local farm, or failing their driving test.

MORE to the point, it facilitates the full appreciation by the consumer of the service supplied to them. If someone knows even a little about cooking, for example, they are much more likely to fully appreciate a dish invented by a clever chef. Nor will the chef, should she come out of the kitchen, feel personally threatened if a diner asks: “Was that nutmeg in the spinach?”

Even Alfred Hitchcock, who infamously said that actors should be treated like cattle, responded to a query about lenses from Julie Andrews by saying “every actress should have a good understanding of what the camera is doing to her”, and providing a 25-minute tutorial designed to help her grasp the technical capabilities of each lens — when, it might have been assumed, he’d have wanted to keep such abstruse wisdom to himself.

It’s arguable that medical professionals should abandon the hope that patients will come to them ignorant, subservient and compliant.

They might usefully, instead, make a friend and ally out of Dr Google.

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