COURTESY OF Martin Westcott:
The Internet is a fantastic and open resource which enlightens us all. If my washing machine is bust that’s where I look first, if my car is bust I search forums looking for answers. I heard a Neil young song the other day and was so moved that I googled and within minutes learnt about the horror of the Kent State massacre. Given the speed with which one can learn of all manner of man’s learning how can we ignore the health of our bodies? If one is so moved to decide a doctors visit is in order in the modern world the uncomfortable appointment call would likely only follow after many hours of googling. It is unfortunate that once you find symptoms that may correlate to some terrible affliction your mind will not let you forget that this could in fact be true for you,
This surely means the googling class will return to you petrified with fear overtly or not again and again.
Am I a googler, would i wait three weeks to see a doctor having not googled?
We are lucky to have free doctors in the uk.. If I lived elsewhere google might be my sole consultant.
There are wiser doctors than me who can explain why “doctoring by numbers” is wrong both ethically and on the basis of it being poor medical practice. I’m thinking of the quantification of depression, estimation of renal function and cholesterol measurement for a start. These point to risk factors, rather than diseases, just like the measurement of blood pressure. I know that I shouldn’t fall into the trap of overmedicalising the symptoms of my patients by trying to quantify their symptoms with a test of some sort. But I do.
“You want a blood test?” I ask my patients, “Sure, what for?” as I open up the all-singing, all-dancing mail merge document for our local hospital that enables me to choose any number of blood tests for my patients. There is probably a rational, non-medical reason for my patient’s fatigue, but I find that I am dealing with a high level of health anxiety.
So, at the root of the problem is a patient population that is encouraged to medicalise their problems, by public health adverts on the radio, and cancer-scare stories in the newspapers and fuelled by “cyberchondria” – the use of internet search engines to diagnose symptoms.
And my response to this tidal wave of health anxiety?
Well, to be honest, I tend to surf the wave and go along with it. Partly to appease my patient, partly because I think the only thing that will reassure them is a normal test result, but partly because I too suffer from health anxiety. More accurately, I suffer from health professional health anxiety…
“What if they do actually have hypothyroidism, or Addison’s Disease, or diabetes, or worse still leukaemia?” says a little voice in my head The voice that was planted there when I did my junior doctor training in hospitals where the explanation of all symptoms was sought through a chest X-ray, MSU and “baseline bloods”. Where the wellness of as person is routinely documented through the tracking of inflammatory markers and absence of deviations from the norm consign symptoms into the unexplainable “functional” bucket.
So, I wonder if the over-medicalisation of my patients in general practice is at least in part due to the health anxiety of patients, fuelled by the media and the internet? I wonder too if I collude with them by agreeing to investigations and yielding to my own inability to handle uncertainty. One day I hope that I will have the experience to know, both intuitively and clinically, when investigations are a waste of time and money. I hope to brave enough to stand up to the tidal wave of health anxiety and medicalisation and learn to be to wise enough to normalise. One day.