Dot Com v. MD: Health Advice & Resources Online
Three-quarters of Internet users in the U.S. are going online to answer questions about their health. But with hundreds of thousands of health websites, separating the useful and reliable from the questionable and potentially harmful can be a tough task. We look at how Americans are using online health resources and how they're changing the doctor-patient relationship.
Guests
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Comparing Online Symptom Checkers & Their Medical Diagnoses
Do an Internet search for "symptom checker" and the top results are likely to be WebMD, Mayo Clinic and Drugs.com. Health websites like these yield a list of possible diseases and conditions that match at least one of your symptoms selected from a drop-down menu of factors. Though all include disclaimers about the medical advice given and recommend calling 911 if symptoms worsen or persist, the variety of possible diagnoses can vary widely among the websites.
For example, a search for the possible cause of moderate knee joint pain in a 25 to 34-year-old male turns up eight to 28 different results:
| WebMD | Mayo Clinic | Drugs.com |
|---|---|---|
| Repetitive Motion Injuries | ACL injury | Ankylosing spondylitis |
| Tendinitis | Gout | Anterior cruciate ligament (ACL) injury |
| Pseudogout | Osteoarthritis | Arthritis associated with Inflammatory Bowel Disease |
| Septic Arthritis | Posterior cruciate ligament injury | Bursitis |
| ACL Injury | Pseudogout | Chondromalacia |
| Bursitis (Prepatellar) | Rheumatoid arthritis | Fibromyalgia |
| Chondromalacia Patella | Septic arthritis | Fracture |
| Gout | Sprains and strains | Gout |
| Knee - Meniscus Tear | Joint infection, including Lyme disease | |
| Knee Strain | Knee sprain | |
| Lupus | Osteoarthritis | |
| Lyme Disease | Posterior cruciate ligament (PCL) injury | |
| Obesity | Pseudogout | |
| Osteochondritis Dissecans | Psoriatic arthritis | |
| Patellofemoral Pain Syndrome | Reiter's syndrome | |
| Psoriatic Arthritis | Rheumatoid arthritis | |
| Rheumatic Fever | Spondyloarthropathy | |
| Rheumatoid Arthritis | Tendonitis | |
| Sarcoidosis | Torn meniscus | |
| Sickle Cell Crisis | ||
| Sickle Cell Disease | ||
| Sporotrichosis | ||
| Stress Fractures | ||
| Ulcerative Colitis | ||
| Crohn's Disease | ||
| Henoch-Schonlein Purpura | ||
| Posterior Cruciate Ligament Injury | ||
| Shingles (Herpes Zoster) |
In another case, trying to diagnosis heart palpitations in a 45 to 54-year-old female can come back with a handful of responses or 17 responses:
| WebMD | Mayo Clinic | Drugs.com |
|---|---|---|
| Atrial Fibrillation | Atrial fibrillation | Sinus tachycardia |
| Panic Attack | Heart arrhythmias | Certain types of arrhythmias |
| Generalized Anxiety Disorder | Hyperthyroidism (overactive thyroid) | |
| Acute Stress Reaction | Premature ventricular contractions (PVCs) | |
| Excessive Caffeine Use | ||
| Heart Rhythm Disorder | ||
| Low Potassium (Hypokalemia) | ||
| Premature Ventricular Contractions (PVCs) | ||
| Mitral Valve Prolapse | ||
| Fibromyalgia | ||
| Aortic Regurgitation | ||
| Atrial Flutter | ||
| Hyperthyroidism | ||
| Supraventricular Tachycardia | ||
| Thyroid Storm | ||
| Vitamin B12 Deficiency | ||
| Pseudohypoparathyroidism |
Ear pain in a child, however, result in more similar diagnoses across the websites:
| WebMD | Mayo Clinic | Drugs.com |
|---|---|---|
| Ear Canal Infection | Common Cold | Common Cold |
| Earwax Blockage | Ear Infection | Fluid In Ears |
| Middle Ear Infection | ||
| Chronic Sinusitis | ||
| Foreign Object In The Ear Canal | ||
| Respiratory Syncytial Virus | ||
| Ruptured Eardrum | ||
| Swimmer's Ear |
Comments
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I very much appreciate this program and your guests' comments. It resonates because I'm a long-term patient with a very rare disease, and over the years, I've learned a lot - sometimes the hard way - about finding good information on the Web and asking doctors the right questions. So - and forgive me for the plug - I created a mobile app - PatientPilot - built around simple interactive checklists to coach patients on asking their doctors questions and finding reliable medical information. We're all patients and we're all swamped by information, so your guests are right - we need guidance to navigate it all.
Thanks, Grant Perry
Access to health information or even care for the general American public is not a "joke" or a social interaction as your presenter Susanna Fox indicated regarding "Dr Google". The general public has to wait weeks to get an appointment with their GP or even specialist and then its a 15 minute pressure filled interview. The parameters are always "you-the patient--must is limited to a "slot" of time. Most public conversations even this conversation puts the responsibility on the patient to know the right questions and more. Our health care is hugely expensive, dysfunctional and generally unresponsive. How else other than online will we have ANY information? Your Pew investigator thinks this subject and her ability to crowd source is humorous, when our health is very serious--we have full lives in order to pay for our health care and because we prefer other interests to our health. My niece had a headache for 6 months and when finally diagnosed it was a brain cancer the size of an orange--this past summer. Thank goodness she was by then in Canada and through her husband had immediate world class care there. Dr. Pareke was very helpful providing other sources; he was helpful.
I recommend an app called Patient Pilot. It has links to authoritative medical information. and interactive checklists to guide patients with important questions, You can also enter your medicine lists and dosages, and share them with other people.
Try not to go to the doctor alone, but remember to take Patient Pilot too. go to PatientPilot.com. It's free.
The Internet has opened up Americans to health care and procedures that are available in other countries, that are not available here. Many of these have been tested and approved in other countries, but have not received FDA approval...or may be in a US testing program. I have found that the US medical establishment is very conservative and resistant to change.
Thanks, everyone, for the comments here and during the show. It's an honor to be part of the conversation about health & health care.
I wanted to clarify that I do not think that Dr. Google is a joke. I have the utmost respect for people who are navigating the maze of health care, using every tool at their disposal to take care of themselves and their loved ones. My remark was a light-hearted way to summarize a decade's worth of research showing that the internet plays a role in many Americans' lives -- hopefully I said what I meant to say: "We joke that Dr. Google is the de facto second opinion in the U.S." The "we" refers to my Pew Research colleagues and I, who are tracking public opinion and uptake of technology.
If you're interested in learning more, all of the Pew Research Center's work is published online, for free. Here is a link to our health research:
http://pewinternet.org/topics/Health.aspx?typeFilter=5
You may also like a blog I contribute to:
http://e-patients.net
And if you're on Twitter, I can recommend all sorts of interesting people and communities such as #raredisease or #bcsm (for people living with breast cancer). My current favorite is #whatifhc which means "What if health care...?"
I wrote this post about it recently:
http://e-patients.net/archives/2013/02/what-if-health-care.html