Internet vs. Doctor: Our Obsession With Self Diagnosis

Aside from the power of Google, which will render a number of anecdotal diagnoses for any symptom you type in the search box, a large portion of medical information available to consumers comes from the media's coverage of sensational studies.
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Every physician I have spoken with recently has smiled and nodded in understanding when we talk about our wonderful patients and their adventures with the Internet. There is an emerging phenomenon where folks are showing up in medical offices across the country locked and loaded with endless streams of data they've managed to retrieve from the Internet in their pursuit of answers -- where did these red spots on my tummy come from; what does this persistent cough mean; what do you mean oatmeal doesn't lower cholesterol? These Internet interludes result in what I refer to as the "Internet Printout Under the Arm" sign. As soon as we enter the consultation room, the patient will whip that wad of wisdom out from their armpit, and then there are three of us in the room -- the patient, the physician and the Internet.

Often, the patient will present him or herself with the tricky combo of the Internet printout firmly tucked under their arm as well as an alarmed look in their eye, ready to show me the latest frightening medical information they've read online or seen on the local news. Or that they'd like to discuss an alternative, herb-based treatment they read about that will surely cure what ails them. And, Lord forbid there's a celebrity associated with the claims. I think it's really important to lay out all options and discuss all possibilities with each and every patient during their appointment. I'm a firm believer in transparency when it relates to patient care. But, like so many physicians out there, I'm concerned about Internet overload as well, and how this may be confusing people.

Aside from the power of Google, which will render a number of anecdotal diagnoses for any symptom you type in the search box (and, most likely, the majority of these diagnoses are not applicable), a large portion of medical information available to consumers comes from the media's coverage of sensational studies. The studies I'm referring to usually concern "red flag" medical conditions that tend to evoke personal emotions -- so many people have unfortunately been touched by common medical maladies such as stroke, cancer, heart attacks, etc.

Oftentimes, these studies also feature a food or a drink you have typically enjoyed for years that is now reported to be associated with one or more of these red flag conditions. Confusion erupts when one study says oatmeal is helpful in cholesterol lowering and the next shows no correlation. The government report citing no need for mammography prior to age 50 resulted in a tsunami of protests from patients and practitioners alike and finally a complete reversal by the government panel. No wonder consumers are getting jaded out there.

Wait, there's more.

How many times have you read about a study touting the health benefit -- or lack thereof -- of eggs? Past studies have shown that eggs were high in cholesterol, and subsequently, maligned by the media due to all of the harmful things LDL (bad) cholesterol can do to the body. However, eggs today are currently at the lowest threat level. In fact, at this moment in time, they're being downright celebrated. New data show that eggs contain 14 percent less cholesterol than previously thought.

The latest studies making the media and Internet rounds concern two everyday items people use and enjoy regularly: diet soda and cell phones. The former was recently reported to show an association with stroke, while the latter is associated with brain cancer. Scary stuff, indeed, and the headlines certainly cause you to take pause. But, it's important to look closely at these studies to understand whether or not there is a causal effect and whether or not the appropriate information was gathered beforehand.

For example, in the case of diet soda, the latest study did not look at whether participants had a family history of stroke. This is critically important knowledge that is missing -- although you'd be hard pressed to learn about it when reading the newspapers. Another missing, albeit needed, piece is knowing whether or not the participants consumed diet soda to offset other unhealthy eating behaviors. Wouldn't knowing what type of foods the people studied were eating help in determining risk factors for stroke? I would certainly think so. This study is also the first one of its kind, and one study does not a final result make. This is why the medical community looks at meta-analyses, which combine the results of several studies for the purpose of discovering patterns and allowing us to draw direct assumptions. And, until I see repeatability -- that is, if the study can be duplicated precisely -- I am skeptical of the reported findings.

So the question begs: how do you, as a patient, make sense of these studies and all of the online medical (mis)information you have instant access to? How can you learn to scrutinize the media hype as well as online information to avoid Internet overload? Here are a few helpful tips:

Engage in an Open Dialogue With Your Family Physician and MedicalTeam

Talk to your family physician, physician assistant or nurse practitioner about your concerns, and ask him/her to explain any studies or reports about which you are concerned. Form a trusting partnership with your medical team and make sure you feel that they will take the time to discuss any concerns you may have.

Develop an Inner Circle of Wise People
Enlist your own group of trusted people you can engage for frequent discourse on common health issues. This inner circle shouldn't be limited to only your medical team. Make sure to include close friends whose opinions and perspectives you trust. Add to that a close blood relative or two, and you have a true circle of wisdom that that can help you navigate the sometimes choppy medical information waters. Bounce ideas and concerns off them frequently.

Seek Out Smart Accredited Authorities and Newsletters
There are numerous places to get practical, smart and informed health advice on the web. WebMD is a fantastic source for all health related issues, and for the latest news about red flag illnesses such as heart disease and cancer. I recommend visiting the American College of Cardiology's and the website of the American Cancer Society, which is found at These sites are full of great information and professional perspectives and serve as great resources to connect you with the information you need about cardiovascular and cancer issues. You might also want to add to this Internet exchanges where people with the specific condition may discourse with one another. These are usually helpful with regard to practical day-to-day information (if you're on a beta blocker for blood pressure, don't bother checking your pulse rate during exercise since it's decreased on this medication).

Be Your Own Advocate
You know yourself better than anyone. If you feel the chest discomfort you're having is something that needs assessment, don't be blown off by people who may say it's nothing. On the other hand, don't overstress everything that you feel. Live a healthy lifestyle and learn to perceive what your body really needs. You are your best advocate and I assure you that people who are proactive and vociferous about what they need, live longer and better lives.

The bottom line is when you're wading through TV, radio and newspaper headlines, remember to look at all of the new studies with a critical eye, avoid falling for sensations and stick with credible data and of course, your circle of wisdom. Internet overload no more!

Dr. Pamela Peeke is an Internationally recognized expert, physician, scientist and author in the fields of nutrition, stress, fitness and public health. She is Chief Medical Correspondent for Discovery Health TV, and the author the bestselling books Fit to Live, Body for Life for Women, and Fight Fat After Forty. She serves as a frequent commentator for national broadcast networks and consults with several food and beverage companies including The Coca-Cola Company. Dr. Peeke holds the position of Assistant Clinical Professor of Medicine at the University of Maryland, School of Medicine and is a Fellow of the American College of Physicians.

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