Heather Copeland had a bad rash. It hurt even before you could see it. It was just on one side, blistery, and very red. Heather's mother had a similar affliction 10 years ago. Heather and her mom both had shingles. The only difference between Heather and her mother was that Heather knew exactly what it was before she went to the doctor. Heather has something her mother never had: Dr. Google.
A just-released survey by Pew Internet and American Life reveals that the next time the average person is seeking reliable information about a health problem, they are more likely to first turn to the Internet for an answer before their health-care provider.
As the number of people turning to cyberspace for help increases, so does their faith in the results. Research in the esteemed Journal of the American Medical Association showed that patients perceived (which may be different than the truth) that the Web increased their understanding and allowed them to self-manage their acute or chronic problems 30 per cent of the time.
Why wouldn't you visit Dr. Google? She is accessible, available 24/7 and has all the time in the world for you. No waiting room filled with coughing people. No speculums or rubber gloves -- in fact, none of that yucky physical exam stuff.
You can check with the doctor, the naturopath, the trainer and your old girlfriend's aunt, who was pretty hot and smart at the same time. You can talk to other sufferers down the street and across the world. You can ask embarrassing questions. Even doctors, many of whom swore they would always divorce the Internet from the clinic, are prescribing websites daily.
The business case for Web self-care is very powerful as it is much cheaper than a clinic visit or ringing up a call centre (which is why it is extremely difficult to find an actual person to talk to on that website for the gizmo you just bought but can't quite turn on).
Dr. Google is not a cure-all, but she has most certainly become a powerful member of the health-care team. But just how effective is she?
Can you separate the e-wheat from the e-chaff?
The Pew study showed that e-patients do what you think they do: They tentatively diagnose their own diseases, confirm their doctor's diagnosis and research all treatment options (not just those recommended by the doctor), give themselves a crash course on a specific medical condition when they (or someone they love) is diagnosed and exchange information and support with other patients with the same disease.
Most do it in a scattershot manner, but a small percentage actually use targeted e-mail health news, participate in on-line support groups or e-mail lists for people concerned about a particular health issue.
However, the same study also shows that only 50 per cent of e-patients actually check the validity of Internet sources. A Stanford study indicates that even those who think they can detect validity are easily misled.
Investigators had users look at three sites, all of which had the exact same health information. The first version provided the content only, the second version included a handsome 30-year-old with a dishevelled frat-boy appearance, and the third site showed the same guy but with slicked back hair, beautiful tie and, of course, the white jacket (picture a young Florida dermatologist). Users felt that each site was progressively more believable, credible and trustworthy.
Who is better: Dr. Google
or Dr. Welby?
The answer depends on who is asking, but likely the real question is what is the right combination? Family-medicine research has shown again and again that the relationship between provider and patient is a key determinant of health.
The Web could augment or deteriorate this relationship and a FirstHealth survey of 1,000 people in the United States revealed this mixed message. On the one hand, 77 per cent believe that doctors will miss subtle clues in on-line interactions that they would normally pick up in a face-to-face visit; 60 per cent feel technology will replace much in-person care, driving doctors even further from their patients.
Yet the survey also showed patients want more: 83 per cent of health-care consumers want lab tests available on-line and 69 per cent want on-line charts managing chronic conditions. We are developing a study in our shop where we look at the effect of sending you an "after visit e-summary." When I discuss the idea with the people I see, they just look at me as if to say, "Of course you should be doing that!"
