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Old 08-26-2019, 08:44 PM
 
1,249 posts, read 1,726,786 times
Reputation: 911

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I rarely mind when a patient looks things up on Google or WebMD. Smart patients often provide good insight. If a patient wants to be tested for a disease that I don't think is appropriate, I'll tell them why, and they almost always agree. If I'm on the fence, I'll test for it, although I caution the insurance company may not agree and there may be costs associated with testing.

What really enrages me, from an endocrinology perspective, is: 1) the "doctor" 20 miles down the road who has an ad on TV saying he can "reverse the symptoms of diabetes". When my patients ask what I think about them going to the "free" seminar, I encourage them to go if they really want to. Three patients came back from the seminar and said they would be charged 9K to 12K to be placed on some sort of exotic rice-only diet. That really ticks me off for the patient. Now I just advise against the seminar if they ask me, and no patient has given me pushback. I spend time at the visits to get them out walking, doing balance exercises, working on diet, and taking medications. It's not about just eating expensive, exotic rice that no one has ever heard of.

Yahoo!News is also irresponsible with their click-bait ads. The top one a few months ago was "Why Doctors are Taking All of Their Patients Off of Metformin" (sigh). Metformin still has its place in medicine for many patients. I clicked through the ads, and there was no new scientific information about metformin, although I knew beforehand because I keep up with my stuff. Good old Yahoo!News clickbait can cost me about 8 minutes of a 15 minute appointment, though, explaining this to the patient.

Also published on Yahoo!News recently was a news story about how someone died from taking generic insulin. Generic insulin, per se, does not kill a patient. The story did not give enough information for me to determine why the patient's blood glucose level would be "17 times higher than normal" just from taking NPH and regular insulin. It was irresponsible, and scared the patients.

Lastly, I happen to love pharmacists. They have saved all of us a time or two. However, we work with insulin-resistant patients, often on high doses of carefully-calculated concentrated insulins which are gradually titrated up (after making sure the patient is actually taking what we are prescribing). It undermines me when a pharmacist reportedly tells a patient, "That's A LOT of insulin!" in a shocked voice when dispensing it. If you have a concern, call us. Don't undermine us to the patient but then not call the office. This usually only happens with one PharmD in town; have not heard stories about anyone else relaying cautionary remarks about "lots of insulin".

Thanks for letting me vent!
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Old 08-27-2019, 01:50 AM
 
Location: on the wind
23,015 posts, read 18,343,985 times
Reputation: 74489
Being a person who is used to doing research and being familiar with more scientifically-based information, of course I read online about a possible health condition in addition to seeing a professional about it. Sometimes it happens before I see them, sometimes after. If something just isn't jibing I call my provider or follow up with a subject matter expert. Sometimes the benefit from all this isn't actually more information, but helping me clarify for myself what I need to ask, or clarifying what I've already been told.

The comment about being able to evaluate the quality or "slant" of information is key. Discernment is important. I don't just read one site that tells me what I hope to hear, I read a number of them, including the ones that I don't agree with, and I also read references they cite too. For most things you'll soon see a pattern; valid information tends to be repeated by different sources. The more wack-a-doodle outliers become obvious. I rarely take .com sources with more than a grain of salt...you have got to realize what their motivation is. The $$. Many spurious claims are circular...they only refer to their own little network of "experts" and you find yourself looping right back where you started with little to show for your trouble.
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Old 08-27-2019, 04:28 AM
 
2,391 posts, read 1,389,601 times
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At the end of the article, the interviewed doctor concludes: But if you need to go to the ER, don’t google first, just go!

Actually, the one time in my life I actually needed to go the ER ASAP, the only reason I went right away was because I consulted Dr. Google. Thanks to a brief search I realized I had symptoms of water poisoning/hypnonatremia and needed to go right away. It helped me convince a skeptical husband that what I realized was mild mental confusion (along with nausea and muscle cramps) was actually a life-threatening emergency. By the time we arrived at the ER, I was already losing consciousness.

Not all life-threatening conditions have extremely painful symptoms which people associated with the necessity of emergency care and using Dr. Google can help you realize that some odd, but painless symptoms are actually red alerts.
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Old 08-27-2019, 05:29 AM
 
Location: Central IL
20,726 posts, read 16,246,928 times
Reputation: 50368
Quote:
Originally Posted by 1+1=5 View Post
I rarely mind when a patient looks things up on Google or WebMD. ...

What really enrages me, from an endocrinology perspective, is: 1) the "doctor" 20 miles down the road who has an ad on TV saying he can "reverse the symptoms of diabetes". When my patients ask what I think about them going to the "free" seminar, I encourage them to go if they really want to. Three patients came back from the seminar and said they would be charged 9K to 12K to be placed on some sort of exotic rice-only diet. That really ticks me off for the patient. Now I just advise against the seminar if they ask me, and no patient has given me pushback. I spend time at the visits to get them out walking, doing balance exercises, working on diet, and taking medications. It's not about just eating expensive, exotic rice that no one has ever heard of.
Thanks for sharing that you give exercise and dietary advice while other supposed "natural" doctors are charging many thousands of dollars for a diet cure that doubtless does little. This flies in the face of what some cd'ers think about doctors. Perhaps they're just seeing the wrong ones?
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Old 08-27-2019, 05:39 AM
 
8,076 posts, read 10,017,178 times
Reputation: 22648
Some pretty reliable medical providers (Mayo Clinic, Johns Hopkins, etc.) put info on the net. That's a pretty significant endorsement of the idea that patients should consult the net to be informed about their medical condition.
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Old 08-27-2019, 05:46 AM
 
2,391 posts, read 1,389,601 times
Reputation: 4209
Quote:
Originally Posted by Ted Bear View Post
Some pretty reliable medical providers (Mayo Clinic, Johns Hopkins, etc.) put info on the net. That's a pretty significant endorsement of the idea that patients should consult the net to be informed about their medical condition.
That’s a really good point.
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Old 08-27-2019, 05:48 AM
 
Location: Texas
44,256 posts, read 64,159,565 times
Reputation: 73916
I love informed patients who try to be actively involved in their own health care by doing research, changing their diet, exercising, etc.

I don't enjoy having to disabuse people of notions they get when they have just enough knowledge to argue but not enough to understand that they don't know how much they don't know.

There are lots of good websites.
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Old 08-27-2019, 06:38 AM
 
Location: The Driftless Area, WI
7,150 posts, read 5,002,629 times
Reputation: 17515
Quote:
Originally Posted by DubbleT View Post
Back in the late nineties I went to the internet when the pediatrician, and the two specialist he sent my son to see, seemed stumped by his symptoms. When I went back to the doctor and told him I thought there was a possibility my son had a rare genetic condition he was extremely skeptical and I'm sure he thought I was probably one of 'those' patients.
To his credit he went ahead and ran a few simple test to confirm the presence of certain markers and when they showed positive off we went to see a slew of various specialist. Thanks to his willingness to consider my 'diagnosis' my son is much more likely to be aware of possible complications of the disease and to live to a ripe old age.
So here's to all the healthcare professionals who are at least willing to listen with an open mind!

Med students frequently, & to a lesser extent, residents want to impress their profs by coming up with some rare diagnosis to explain a pt's condition. We tell them, "When you hear hoof-beats coming down the road, it's probably a horse and not a zebra." ...But then, every once in a while, a zebra does escape from the zoo.


Your doc was open minded. That's good. It's a cardinal error for a doc to get too locked in to his first diagnosis.


Advice for pts who want to educate themselves about their symptoms or diagnosis: stick to the reputable med sites like WebMD, Medscape, Mayo, Cleveland Clinic, etc. If the article is published in the popular press, like NY Times, Cosmo, Better Homes & Gardens etc-- skip it or at least read it with extreme skepticism...Even Wikipedia, which claims to be open & unbiased, is not always what they claim.
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Old 08-27-2019, 07:12 AM
 
Location: San Antonio, TX
11,495 posts, read 26,773,863 times
Reputation: 28030
When I started getting sick a few years ago, the internet was much more helpful than the specialist I saw. The specialist said I had anxiety that was causing all my other symptoms. From googling my symptoms, I was able to find a combo of OTC meds that helped me, and from finding an online group for the health condition I have, I was able to find a local doctor who understands what's wrong with me and knows how to treat it. If I had listened to the specialist and not done my own research, I wouldn't be getting better like I am now.
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Old 08-27-2019, 08:09 AM
 
9,789 posts, read 7,599,691 times
Reputation: 24356
Before the internet, I used to go to the library and research medical issues. Should I let my OB deliver the baby breech or do a c-section? How do we stop my son's constant ear infections and resistance to antibiotics (Dr Weil said they don't help - surprise)?

And in the early days of the internet, I found a support group that gave me answers as to why I had daily hives for 20 years (diagnosed chronic idiopathic urticaria and angioedema) and why I should wean myself off of the long term prednisone I was taking.

And oh my, on the minor, bizarre health issues, of course Google is awesome. I had a burst of oil on my scalp, so strange, that would get worse with shampooing. Googled it and found hundreds of fellow weirdos that had the same thing happen, who had gone to doctors, hairdressers, analyzed different products, etc and finally someone found a way to clear it up.

I think it's a good thing for people to deal with their minor issues themselves instead of taking up valuable health resources. Leave that for the people with serious health problems.
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