(For those who need to be told – yes, that was sarcasm.)
When I used to work in the health sector, we had a phenomena called the “heart-sink patient”. I am sure they still exist. Everyone working front-line knew what this phrase meant.
The heart-sink patient was the patient who, when the doctor went to the waiting room to call the next patient, literally made the doctor’s heart sink.
Now there were a few sub-categories of heart-sink patient. There were those who had a genuine condition that defeated all attempts at diagnosis or treatment – frustrating and reminding the doctor of their own fallibility and limitations. There were those who had unrealistic expectations – either for instantaneous cures, or who medicalised the ageing process and wanted it stopped. There were those who had self-inflicted illnesses and refused to address the underlying cause – leaving the doctor to do ongoing patch-up medicine, knowing that the illness was only getting worse (for example uncontrolled diabetes). And of course there were the drug-seeking patients, many of whom were highly manipulative, disruptive and unpleasant.
I suspect there is now an additional category. The Google patient. When I left the health sector this was already quite prevalent – the patient who came in having looked up their symptoms on the internet and done a self-diagnosis. Sometimes they come in quite panicked, having diagnosed terminal illness. Sometimes they would come in demanding irrelevant and expensive tests for some highly improbably diagnosis, or requesting a prescription for a drug without having any form of examination or investigation (not going to happen). Either way, it made consultations longer – although, I am told – sometimes more interesting. And of course sometimes Google had managed to give them a correct diagnosis.
Given a list of symptoms, we are quite capable of generating those symptoms in ourselves. Remember when someone at work had a raging flu and you started to feel an itchy throat and snuffly sinuses – and it went away the next day? Let’s be nice and call it empathy taken to the next level. Well, reading about symptoms and illnesses can have the same effect. Author Jon Ronsson looked at the DSM IV – the diagnostic manual for psychiatric illnesses – for his book The Psychopath Test: A Journey Through the Madness Industry and diagnosed himself with twelve of the conditions. Now I don’t know the man, so I can’t be sure he doesn’t actually have any of these conditions, but I suspect he is just identifying with the symptoms listed. We human beings are so suggestible!
However Google is now helpfully taking this to a new level. Using search algorithms, if you type in symptoms – say “stomach pain on right side”, they will suggest a series of possible options – appendicitis, ovarian cyst, etc. Google is very clear that these lists are not compiled by medical practitioners and they are also not offering these as diagnoses. Just linked searches. They would not want to be getting involved in the convoluted world of medical liability.
So will Google’s new search function aid access to reasonable diagnostic options? Will they screen out the quackery the way Google Scholar (for the most part) screens out the opinion and focuses on peer-reviewed journals? Will this aid doctors, or by using search algorithms are they potentially funneling people and their diagnosis down the most common options – after all, someone has to have the bizarre and very rare illness.
The danger is, I suspect, if the patient having done a quick self-diagnosis on the web (and no matter whether Google says it’s a diagnosis or not, that is how patients will consider the information), then subconsciously edits or reframes their symptoms to fit their self-pre-determined diagnosis when they visit the doctor (because we all like to be right), then the doctor may also be funnelled into making an incorrect diagnosis based on the biased infromation s/he is presented with.
As they say, medicine is as much art as science.
Google’s Chief Health Strategist Dr Roni Zeiger’s blog post on this issue is here.