For years I have bemoaned the fact that people are not reading as much as they used to. In reality what I was really telling myself is that they weren’t reading the things I thought they should be reading! (See my list below.)
As someone who always is in the midst of three or four books, I felt everyone should do the same. But people are reading – it’s just now on the web. And a lot of what they’re reading is medical advice.
Like so many other things in life, the internet presents a two-edged sword. There is the positive of wanting more knowledge, to learn, to better oneself. When used to help others I can think of no more noble pursuit. When patients are researching their medical condition, the web can lead to a healthier lifestyle and better outcomes with the right information. Patients who research reputable government and other medical sites often come armed with really good questions that can help us make the most of our appointments.
The downside, however, is sorting out truth from fiction, fiction from danger, and knowing where our own limitations end. The internet not only provides us with a lot of information legitimate and otherwise, it can lull us into the false security that we can become experts on anything. Want to drop a new tranny into your ’68 Firebird? Ask Google. Trying to decide which way the derivative markets will move? Ask Google.
Many patients realize there is a lot of a misinformation out there and take things with a grain of salt. Others become scared if they read the most extreme disease a symptom may represent, while others believe that if it is on the internet, it is gospel truth. What needs to be understood is even the most “professional” looking website can spread dangerous information without any proof to back it up. And: many websites that come up first paid to be listed near the top.
And despite the celebrity and gossip media’s penchant for asking celebrities what fad diet to be on, the bottom line is this: Money and fame do not equate with knowledge.
I know a lot of physicians – present company included – cringe when patients want to talk about their internet searches. There’s a reflexive inner response that says, “Oh boy, here we go down the rabbit hole.” We wish they would just trust what we say. After all, why else would they have come to see us?
I’d like to propose a reason beyond why people do online medical searches for more knowledge: some don’t trust us anymore. Or at least they’ve become more skeptical. And that’s OK. Skepticism can be a healthy defense mechanism. But the net throws so many differing views at us that one can become skeptical about everything. Factor in the truth that we all have stories, personal or otherwise, about poor medical outcomes, and it’s easy for doubt to creep in. Or storm in.
Medicine doesn’t always get it right. We do make mistakes. And as I’ve said here before (as many physicians have before me): Medicine is as much an art as it is a science. We study medicine for years, train for many more, soak in more information by the day, and still find that we are surprised by outcomes. Sometimes the news is not what we hoped. Sometimes it’s wonderful. There are patients who astound us with recoveries that did not seem possible.
I still believe in the altruism of medicine. I still believe that the vast majority of us who care for patients do so as a result of a greater calling to make this world a better place. And I believe that when patients come to us with their internet info, they are doing so because they still trust us, and want us to separate fact from fiction. Otherwise they would have accepted what they read as fact and moved on without us.
The “I read it online” statement is really more of a question. The sheer volume of information out there can quickly become overwhelming and confusing, and our patients need us to sort things out for them. It is our duty to understand that. So I look at this way: Compliment my patients on taking the initiative, and explain to them what is sound evidence, what is junk science, and what is just plain nuts.
Well, maybe not in those exact words.
To my earlier point. I've got recommendations for three books that I found fascinating. Maybe you would enjoy them, too:
Fun: “Stormy Weather,” by Carl Hiaasen. He’s a native Floridian who nails the quirks of my home state.
Medical: “The Body: A Guide for Occupants,” by Bill Bryson. Just published. I guarantee that regardless of one’s medical background, you will find it fun and informative.
Serious: “The China Mirage: The Hidden History of American Disaster in Asia,” by James Bradley. A really fascinating book about the U.S. relationship with China over the last 150 years. Explains why we are where we are today.