Checking symptoms online leading to growing levels of ‘cyberchondria’

Ray Walley: IMO chief.

Checking your symptoms online rather than visiting the family doctor is leading to growing levels of “cyberchondria” — where patients believe themselves to be far sicker than they actually are.

That was the stark warning issued by Dublin-based GP Mark Murphy during a workshop on mobile health, telemedicine and patient confidentiality at the Irish Medical Organisation’s AGM in Sligo.

Dr Murphy described cyberchondria as “a deep-rooted anxiety” in the patient fuelled by a heightened perception that they are ill having googled their symptoms.

He said a study of 22 accredited online “symptom checkers” published in the British Medical Journal last year showed they overstated the risk to the patient, making them more anxious.

Dr Murphy said apps did not take into account the patient’s psychosocial issues.

And while he had no difficulty with patients turning to accredited websites for information on their condition, it should be after the doctor has delivered a diagnosis, to avoid situations where “patients who have reflux disease think they have oesophageal cancer”.

The workshop also heard from Dr Ray Walley, outgoing IMO president, who said while telemedicine had a supplementary role to play in the delivery of patient care, it was no substitute “for a face-to-face consultation”.

Dr Walley said GPs were responsible for raising almost a quarter of patient problems during face-to-face consultations, on foot of a physical examination or a chat with the patient.

Dr Walley said he knew of a patient who had been diagnosed with depression via video consultation with an online psychiatrist. The patient subsequently presented at Dr Walley’s practice looking for a prescription and a face-to-face consultation revealed suicidal ideation. The woman, who was from overseas and had no support structure in Ireland, was referred to an acute mental health unit.

Dr Walley said while telemedicine had benefits in chronic disease management, it presented challenges in acute medicine.

Dr Murphy said to think that the initial GP consultation can be delivered via technology “is just a fallacy”.

Dr Walley said growth of up to 30% was projected for the telemedicine sector.

Doctors raised a number of concerns around data protection and patient confidentiality at the workshop.

Jim Gregg, professional development consultant with the Irish Computer Society, said EU General Data Protection Regulations 2016, which he predicted would be in force in Ireland by 2018, would mean presumed consent would disappear “and it will have to be explicit consent”.

In relation to data protection, Mr Gregg said it was “a can of worms, but a can that has to be opened”.


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