Written by Nirmalya Dutta |Updated : April 17, 2014 2:50 PM IST
The Internet is creating new-age hypochondriacs, an all-India doctors' survey reveals. Are you one of those people who googles lumps + cancer the moment you spot a bump on your body? Do you imagine suffering from an ailment only because you have read about it on the internet? Have you ever indulged in self-medication, or advised a family member/friend to take a particular medicine, after reading about it online? If the answer to even one of the questions is a 'yes', then you're a doctor's worst nightmare come true. A recent survey, conducted across 27 cities including Mumbai, Pune, Delhi, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad revealed that doctors have been struggling to deal with patients who use the internet to find out what ails them.
Those are the opening lines of an article titled 'Doc, the internet says I have cancer', in the Mumbai Mirror suggesting perhaps that the internet in general, and medical websites in particular, were a doctor's worst nightmare. The internet has been without a doubt the defining invention of our times. It has allowed the exchange of and access to information at a rate that just wasn't feasible for our ancestors. It has given anyone, with a decent internet connection, access to any sort of information feasible. It governs how the world is run, bringing us news and info at breakneck speed and influences every aspect of our lives, including the upcoming elections of the world's biggest democracy. But is it too much information a dangerous thing? Does it bring imbalance in the healthcare system where much power lies with the doctors and healthcare providers or does it hatch ill-informed patients who start challenging the ones providing the treatment?
Dr Aniruddha Malpani, an IVF specialist and a vocal supporter of information therapy and patient advocacy believes that this is an archaic, luddite-like attitude of the doctors. He says: 'This is a completely archaic attitude in my opinion. Most good doctors are very happy to talk to internet positive patients, because they are well-informed and have realistic expectations. Patients who have done their homework actually have a better doctor-patient relationship, because the doctor has to treat them like intelligent adults, who have an opinion about their own health and would like to decide their own treatment options, in partnership with their doctors.' He adds: 'I believe that patients are the largest untapped healthcare resource and that information therapy the right information at the right time for the right person can be a powerful medicine.'
Dr Sumeet Shah, a Consultant Oncologist, practicing in Mumbai and also a vocal advocate of breast cancer awareness doesn't think the internet is a hindrance when dealing with patients. He says: 'Not at all (when being asked if the internet is a hindrance). While occasionally, I come across a patient whose mind is completely filled with incorrect information read on the net; these patients are few and far between. For most patients, I believe the internet is useful.'
Not just about symptoms and diagnosis
There seems to be an impression that medical websites are just about finding info about the various symptoms and diagnosis. An analysis of TheHealthSite.com's data suggests that just about 10% of the searches land up on articles about symptoms of diseases. In fact, health websites play a far more diverse role than doubling up as an online doctor or symptom checker. People coming to TheHealthSite.com search for a variety of terms including home remedies, causes of diseases, general health tips, treatment options, second opinions, to understand how tests work, alternative medicines, life after being diagnosed or treated with certain ailments and even prevention. The basic difference between a doctor's visit and an online visit that while a doctor is an illness specialist (you only see one when you're ill), a health or medical website can be visited at any time to learn, to discuss and to prevent ailments. It is closer to a healthcare specialist than the doctor.
But are doctors afraid of a well-informed patient?
For years, doctors and to a certain extent other healthcare practitioners enjoyed an exalted status in the healthcare system. They almost doubled up as gods, people who would listen to their advice and follow everything they said. But then came the internet and with information which helped create a more well-informed patient. Does this make the doctors worried about their status? Dr Sumeet Shah says: 'Not really. No, I am not afraid of the informed patient. Rather, it makes my life easier (when the patient is informed).'
Dr Aniruddha Malpani agrees: 'Good doctors are empathetic and understand that patients are worried when they are sick. Patients have lots of doubts and doctors will proactively try to clear these and answer their questions. Doctors and patients are on the same side the doctors'. Bad doctors may feel threatened, because they are not sure about their knowledge base or competence.'
Hazards of information overload and wrong information
The term cyberchondria was first used in the Independent in 2001 and the word is a portmanteau of cyber and hypochondria. The term is used to describe 'the unfounded escalation of concerns about common symptomology based on review of search results and literature online'. For the uninitiated Hypochondria refers to a mental condition, where an individual is convinced he or she suffers from a debilitating condition due to inaccurate perception of the condition or mind despite the absence of an actual medical condition. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness. But it's not just the cyberchondriacs who suffer due to wrong info.
Dr Pankaj Chaturvedi, a cancer surgeon at the Tata Memorial Hospital, Mumbai says: 'Medical knowledge is very vast and websites give just the tip of the iceberg. However, the internet and social media they play an important role by educating the people and making them aware about their health problems. This helps the patients to understand their treatment better and also helps the doctor in counselling them.'
According to him the problems arise when a patient is misinformed. He says: 'After reading these websites a patient should not feel that he has become a doctor and can make his own diagnosis or treat himself. Rarely, it creates an awkward situation for a doctor where a patient insists on unnecessary investigations or treatment. But the patients should understand that the half knowledge they have got from a website cannot supersede the clinical judgement of a doctor.'
Dr Jaishree Saharad, VP of the Cosmetic Dermatology Society of India and CEO of Skinfiniti Aesthetic Skin & Laser Clinic, Mumbai recalls an event which perhaps epitomises the dangers of misleading information: 'Not everything on the internet is correct and it can get very irritating. In 2012, the Mumbai Mirror carried an article which was also available online which one of my patients read and applied garlic to get rid of her pimple marks. She ended up with burns and scars so not everything online is correct.'
Nutritionist Dr Neha Sanwalka agrees: 'When patients get their information from unreliable sources and blogs written by non-specialists, it can be a particular hindrance. The internet is flooded with loads of info regarding nutrition and crash diets and a lot of it is just myths and not evidence-based science. As a nutritionist, it becomes very difficult to bust these myths especially if they are written on blogs or Facebook page of a well-known nutritionist.'
Dr Sumeet Shah adds: 'The biggest danger of information overload, and wrong information is clouding of mind of the patient. They have read a certain thing for the first time, and if it is partial or incorrect information, it is very difficult for them (patients) to grasp what actually is the truth. And then they start doubting the doctor's decision as well, just because they read something else on the net. It takes a lot of effort to convince such patients (though they are rare) the logic behind a particular medical decision. It is these 'ill informed' patients who end up on a 'doctor's shopping' spree. They consult three or four doctors and end up being more confused than ever.'
There's also the danger of self-treating. Dr Sanwalka reveals: 'Information overload is dangerous because with more information patients tend to self-treat themselves with drugs based on their symptoms and this can be really dangerous because there are many drug-drug or drug-nutrient interactions which are not spelt out on the internet and self treatment can lead to further deterioration of health.'
What the internet can do for us
All that being said there's no denying the vast potential the medium provides for allowing healthcare info to be available to all. From someone sitting in a remote place without a consulting doctor, to someone who doesn't have the resources to seek a doctor's appointment every time someone in the family takes ill, medical information online is a boon for many. On TheHealthSite.com, we receive so many questions every single day from people about queries which are then answered by experts that deal with so many issues. While it's like our disclaimer says by no means a substitute for advice from a healthcare practitioner, there are many who can't afford visiting one. There's a term in politics called realpolitik which is 'a system of politics or principles based on practical rather than moral or ideological considerations'. The same goes for the internet and healthcare, while it's easy for some to sit in their ivory towers and harp about the dangers of seeking information online; there are millions who benefit from the ubiquitous nature of the internet.
How to pick a good health website
All said and done it's therefore very important to pick the right website for your information. A good website by thumb of rule will have:
Dr Malpani, adds when asked about how a patient can find a good website: 'This is usually applied common sense. For example, health websites run by the UK govt and the US govt are likely to be reliable! Patients need to be critical and to do their homework, so they can become well-informed consumers. Just like they spend a lot of time searching for the best restaurant, they need to spend time in looking for good websites, which they can trust a good medical website is a win-win for both doctors and patients.' In his opinion, a good website should allow patients to:
Dr Pankaj Chaturvedi adds: 'People should never visit or believe in websites who promote miraculous treatments or spurious products. To identify a good website make sure it is linked to recognized institutes or medical associations, the articles are written by renowned doctors, the references are quoted from authentic scientific literature and not from newspapers or magazines. These websites are very helpful when used judiciously and should complement one`s treatment and not supplement it.'
The Bottomline: Medical websites are here to stay and it would be silly to dismiss them just because some people get agitated about their condition after reading information online.
Disclaimer: The author has been with TheHealthSite.com since its inception and is heavily invested in its success. Views are personal, TheHealthSite.com doesn't necessarily endorse those views.
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