Consulting Dr. Google

Last week I attended a potluck.  As we were eating, right in the middle of a nice conversation, one guy took a call on his cell phone.  His end of the conversation sounded something like, “What?  That’s all they think it is?  Well, go back in there and tell them you want a CT scan.  No, it’s important.  You need a CT scan.”

I’ve heard of this phenomenon, but this was the first time I’d seen it.  I shook my head in disbelief and said, “No.  Do not tell doctors what tests to order.  If you visit them for their expertise, then listen to them.”

I somehow had the idea that it was the alcoholic/welfare-dependent/ER-abusing/psycho dregs of society that were stupid enough to do that.  To hear an employed, seemingly sane person advocate that someone should demand an expensive medical procedure (one that is not without risks) was…  beyond belief.

It turns out that this guy decided, based on something he read on the internet, that a CT scan was appropriate for his friend.  The internet is a great resource.  There’s a lot of good information available.  There’s a lot of garbage out there, too.  Consulting with Dr. Google can provide just enough information to be dangerous.

The key is to filter out the junk.  It doesn’t make much sense to use a general search engine for reliable medical information.  Whether you like google, dogpile, askjeeves, or something else for general inquiries, doesn’t it makes sense to go straight to medical resources for medical information?  I used to use WebMD, but a doctor pointed out some errors there, so I’ve gone elsewhere.  Family Doctor, Mayo Clinic, Johns Hopkins, and Up to Date are all reliable resources.  Some doctors have started posting short, educational videos on YouTube.

Doctor D’s latest post addresses this very phenomenon.  Apparently people read things on the internet, then see their doctors and demand unneeded tests.  Insurance companies don’t like paying for all those tests, so they raise your premium to make up the difference.  People pay a higher premium, plus their portion of the fee for the unnecessary tests.  Everyone’s health costs go up when this happens.  Go visit Doctor D’s blog and click on the video he shared.

His closing question asks,

So what do you think? Does being an educated, web-savvy patient make you
cost the system more? Do you think reading Medblogs make your
healthcare cost more or less?

I tried to post a short response over there, but blogger kept eating my comments.  Four tries yesterday and one today.  The screen flashes, and my comment disappears.  I’ll just respond here.

I doubt that I count as web-savvy, but my vote is less.  Definitely less.

One example:  my PCP listed a few possible diagnoses and said that I could get an x-ray to find out which it was.  Based on what I’ve read on medblogs, I was able to ask, “What would be the difference in how this is treated?”  None at all.  My goal is not a specific label; my goal is to heal.  If the only thing that will help is giving it more time, then x-rays really aren’t necessary.  Test avoided, money saved.

I’ve learned a ton from medblogs.   Maybe someday I’ll make a list.  Getting the perspective of doctors is incredibly helpful. 

If people are demanding tests that they don’t need, then they don’t really count as educated patients.  More like half-educated.  Obviously they didn’t get enough information from Dr. Google.  Medblogs can help fill in the missing information.

5 thoughts on “Consulting Dr. Google

  1. I hate that doctors lump all patients into one big category — most assuming that patients are half-wits. Doctors need to be more discerning. I became disabled at age 50 seeking competent care. All I got was endless referrals for more tests and more specialists. Each test yielded a result in another specialist’s field until I had enough positive test results to include all the specialties consulted — yet none did anything but make a referral (after the tests, I mean). The only way I was able to get any type of treatment is to do a wealth of research and present similar cases and the treatment protocol followed by a known physician. I guess the doctors figured they were safe ordering a treatment if it had been done before with success by someone else they recognized. Tell me, whose the doctor here? I can tell you now on SSDI and Medicare, I’m getting the same run around. The colon surgeon referred me to a urogynecologist who referred me back to the colon surgeon and to a gastroenterologist. The MRI report was found to be in error and so now the urogynecologist is also looking for a radiologist who can read it. Insurance reform won’t fix doctors’ blindness from a business model that puts $$$$ before patient welfare. Teamwork will. We need something to incentivize doctors to work together to come up with an accurate diagnosis and treatment and stop this repeat and excessive testing and needless referrals.

    • First I thought you were a doctor, then I realized that you have the blues from seeing so many doctors. I’m very sorry to hear of your situation.

      My experience hasn’t been that way at all. With rare exceptions, I’ve gotten along well with my doctors. None of them have treated me like a half-wit. My doctors have been respectful, caring, and compassionate. They’ve all listened to me (even the few I didn’t like personally), telling me when they could help and when there wasn’t anything they could do.

      When I saw two different specialists and didn’t understand either one of them, I phoned my PCP’s office and asked if I could make an appointment just to ask questions. That was one of the best things I ever did. The only thing I’d do differently (hindsight being what it is) is to ask if I could reserve two appointment slots to ensure enough time. My doctor took all the time I needed, which means he was was only paid for a 20 minute appointment even though he took a full hour to answer my questions. He certainly could have watched the clock and asked me to make another appointment, but he didn’t. He put my needs ahead of money, and it made him behind schedule the rest of the day. He answered all of my questions clearly and explained what was happening. I left with a much better idea of what was going on and what to expect in the future. If only there were some way I could repay him or adequately thank him.

      I don’t know if you see a family practice doctor or an internist for your primary care, but that’s who should be coordinating everything for you and helping you navigate the confusing healthcare system. A primary care doctor looks at the big picture instead of one fragmented piece. Best of luck getting the treatment you need.

  2. My primary care doctors were the ones who referred me to a grab bag load of specialists, but not the specialists I needed to see to address my gastrointestinal problems — my main complaint. Then, contrary to their contracts with the medical insurer (Cigna) which does not permit delegation of care, they failed to monitor what the specialists found. Instead they asked me for updates when I was sent back to them. When I told them that the specialists did not concur with the primary’s diagnostic guess, the primaries threw up their hands proclaiming “I wash my hands of it!” It being me and my treatment. That’s why I switched from my first primary doctor after 20 years to another who was no better. The system is not set up to deal with patients who have more than one symptom. I live in Northern Virginia outside of Washington, DC. Maybe people here are more callous and money grubbing. I’m open to referrals. Now on Medicare, I can go to any doctor in the U.S. that accepts Medicare. I know I must sound bitter and like a real downer. However, if I had no hope (positive belief that good people are out there), I’d just sit home instead of continuing to seek competent care. I just haven’t found that doctor yet. I stopped blogging about my doctor experiences which are on-going as I want to give them all the benefit of the doubt.

    • That sounds really rough.
      Are you saying that your primary doctor discharged you? Or was just frustrated? You’re speaking of plural primaries – a large practice where you saw whoever was available? Not that I guess it matters, but it’s a little confusing. I see one doctor as my primary physician.

      There’s a picture of a book in my sidebar: How Doctors Think. You should be able to find a copy at your public library. The first time I read through it there were tons of tips that I thought “I should remember that,” then promptly forgot. The second time I read it, I kept paper handy for taking notes. There’s a lot of good information in there about talking with doctors. Not that I don’t still have a lot to learn, but I really found it beneficial. If you have a library close and time for reading, I’d recommend it.

      It is possible that things are really expensive in NOVA. I was going to ask if you’ve considered scraping together the pennies to see someone at DocTalker Family Medicine (Vienna), but it looks like their “discounted” prices are more than my PCP’s un-discounted prices. I had the impression that they cost less since they keep their overhead low. If that’s low, then it might be worth your while to cross state lines.

      Best of luck.

  3. Sorry about the trouble with the comments. I don’t know what that was about.

    By the way I’m definitely not opposed to educated patients, I was just saying that the education needs to be balanced with perspective.

    You are so gracious to doctors, Warmsocks. I wish I could say all of us deserve it. It is tricky and I understand where doctorblues is coming from. You are supposed to trust us, but then again we are far from perfect.

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