Here at AgingOptions, we’ve written many times about the importance of choosing the right doctor. Getting age-appropriate medical advice and care is an essential part of maintaining good health. But here’s a guilty secret: all too often, many of us are tempted to consult so-called “medical experts” we’ve never even met.
We’re talking about the tendency most American adults have to consult online websites and symptom-checking apps when we have a health concern. In this 2022 article from NextAvenue, New York-based writer and psychotherapist Barbra Williams Cosentino explains why “Doctor Google” is America’s most popular physician, and why that can spell trouble for our health and well-being.
The Appeal of Online Search is Clear
While she admits to loving medical shows growing up, Cosentino begins her article by stating, “My favorite doc now is Doctor Google and I’m not alone.” According to a 2021 JAMA Network Open survey of 5,000 participants, almost two-thirds of Americans go online to search for info about their symptoms in any given year. That’s a whole lot of patients on Doctor Google’s roster!
It’s not surprising that so many people reach out to online resources before calling their own physician. Cosentino quips, “You can search online 24 hours a day, you don’t have to deal with sick patients in the waiting room and you’re never asked for your Medicare or insurance card.”
But the results can be either comforting or sinister, depending on your point of view. They can also be inaccurate or misleading. “You can also manipulate your search to get the results you want or start your search anew if you don’t like the results,” Cosentino writes. “Doctor Google can be reassuring, but occasionally terrifying.”
Cyberchondria and the “Nocebo” Effect
This propensity to use online medical search has given rise to a new term: cyberchondria. In Cosentino’s words, cyberchondria is “an intensification of irrational fears about common symptoms in those who already tend to see worst-case scenarios lurking around every bend.”
On the other hand, over-reliance on web searches for medical symptoms can also cause what Cosentino calls a “nocebo” effect. That’s a sort of self-fulfilling prophecy “in which people with expectations of adverse effects (such as bad side effects from treatments or medications) are more likely to experience them.” These terms – cyberchondria and nocebo – may be playful and tongue-in-cheek, but the consequences are anything but.
Online Discernment Demands Digital Literacy
This isn’t just a search engine issue. Facebook groups, virtual communities like HealthBoards, and health management platform such as PatientsLikeMe are all culprits here. “While they can provide terrific support and often offer useful information,” Cosentino writes, “caution is needed since many are not professionally curated and may be rife with unsubstantiated opinions or advice.”
Because of this, a bit of “tech savviness” is important if you want to sift through online health information to differentiate between what Cosentino calls “the unproven, the quackery, the probably plausible and the solid medical explanations and guidance.” Internet research is something that can be practiced and improved, but it does require the ability to parse out the fact from the fiction. That’s something that can be very difficult in today’s digital world.
To Use or Not to Use – That is the Question
You might think that doctors would be less than enthused about patients using online healthcare databases, but Cosentino finds this isn’t entirely the case. “Most health care providers believe that using the internet for health searches does not undermine the doctor-patient interaction,” she writes. “Knowledgeable patients can contribute positively to a collaborative experience, even though that may lengthen the visit, by being cognizant of relative merits, limitations and risks of a suggested medication or test. Patient-centered decision making (decisions based on patient values and goals) can be the result.”
Paula Belsh, a nurse in Oakland, California, agrees. “I have found that many patients have done their due diligence, researching their medical conditions and the planned or proposed treatments. We encourage them to use medically respected websites such as that of MD Anderson Cancer Center or the American Diabetes Association, and to look at more than one source.”
She concludes, “When used properly, the internet can help people to become well-informed and to understand that they have health care choices and options.”
Doctor Google: What You Need to Know
The most effective—and this term used loosely—of all the online healthcare programs is probably the symptom checker. These online questionnaires use algorithms to help someone self-diagnose and figure out their next steps. While considered more useful than simply googling your symptoms and seeing what pops up, symptom checkers still need to be used cautiously.
Quoting a 2015 study of these checkers, Cosentino warns, “The algorithms listed the correct diagnosis first in only 34 percent of cases, the right diagnosis was included in the top three diagnoses in 51 percent of cases and an accurate diagnosis was within the top 20 diagnoses given in 58 percent of cases.” Part of the issue is that symptom checkers don’t account for family histories, medications, chronic conditions, or really anything that might individualize your diagnoses.
One place where they could even be said to shine, however, was in triage decisions. Cosentino explains, “Triage decisions, which are decisions made by the individual, such as, ‘should I call an ambulance?’ were found to be diagnostically sound in only 57 percent of cases, although this number was significantly higher in emergency cases such as possible heart attacks or strokes.”
In the end, when in doubt, it really is best to call an actual physician – or even 9-1-1.
e-Health Browsing Tips
In her article, Cosentino provides a bulleted list of tips for browsing for health information online. You can check her article for the full list, but we’ve summarized here:
- Use the most reputable websites you can find: Mayo Clinic, PubMed, and The Cochrane Library are all reputable and useful resources, but any site attached to a well-known institution or organization is a good bet.
- Look for “.gov,” “.edu” or “.org” in the web address, which means that it’s run by a government, educational, or professional agency or organization.
- If you’re reading a blog or article, always check the credentials of the person writing it, especially if they claim to be a doctor. And be sure to check the date it was written, too!
Looking for health advice online doesn’t have to be scary or confusing. In some cases, it can even be a free, convenient way to learn something new about yourself and your health. But a little savvy and an ounce of investigation can go a long way to make sure you’re finding credible information, and not junk.
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(originally reported at www.nextavenue.org)