WATPA: FW: Calling Dr. Google

From: Norm Jacknis <norm@jacknis.com>
Date: Mon Jun 26 2006 - 20:40:22 EDT

As we complete the video on health care information on the Internet, here
comes the Journal News with this front page story today. I guess we're on
to something ...


Calling Dr. Google

Checking medical facts online can be OK, but don't become a 'cyberchondriac'

 <mailto:mklein@lohud.com> mklein@lohud.com

(Original publication: June 26, 2006)

The young woman waiting to be examined by Dr. Minerva Santos in her Yorktown
office was crying hysterically. "What is it?" Santos asked her. "What's the

The woman told Santos that she had been up all night, sure that her
abdominal pain was pancreatic cancer.

How did she reach that awful conclusion?

A consultation with Dr. Google.

An examination by Dr. Santos revealed the real illness - constipation.

"She had, like, an upset stomach from that," said Santos, an internal
medicine and pulmonary specialist affiliated with Hudson Valley Hospital
Center in Cortlandt.

It used to be that the family doctor was the font of medical knowledge, an
authoritative voice to be followed without question. Now, anyone with a
computer can play doctor and with a few clicks of the mouse become convinced
that their headache is a brain tumor and their fatigue is Lyme disease.

Doctors say they frequently encounter these cases of what has been called
"cyberchondria" and have to talk people out of what they don't have.

Such cyberchondriacs have become part of the conversation at doctors'
lounges in hospitals, said Dr. David Brogno, a cardiologist with Hudson
Heart Associates in Suffern.

"They think a nice Web site makes a good doctor," said Brogno, who remembers
a patient asking if a pacemaker could be inserted into him after he
experienced shortness of breath.

To back up their claims, patients will sometimes bring a stack of computer
printouts to the doctor, a practice some physicians admit is more a
hindrance than a help. Brogno said he asks such patients to make a synopsis
of the printouts for an easy read, and that will frequently discourage those
who haven't done serious research.

At the same time, Santos, Brogno and other doctors say the Internet does
have a legitimate place in health care if used judiciously to learn more
about a condition or treatment.

"There is so much information out there - there is good information and bad
information," said Dr. William Cors, a neurologist and vice president of
medical affairs at Good Samaritan Hospital in Suffern. "I don't know if
people fully appreciate that not all the information out there is valid.
Having said that, I believe it's better that patients have access to

Even before the Internet age, patients would come in with an idea of their
diagnosis formulated by paging through a reference book or talking to family
and friends, Cors said.

"Look, we had hypochondriacs before we had the Internet. You had people
reading the Merck Manual at Barnes & Noble. Now you have the Merck Manual
online," said Cors, referring to the layman's bible for medical diagnosis
and therapy. "But it still requires caring, concerned, helpful physicians to
help patients separate myths from reality."

The vast majority of Internet users - 79 percent - have looked up
information on at least one of 16 health topics, mostly a specific disease
or problem, according to the Pew Internet & American Life Project based in

Popular search topics include those on a particular treatment or procedure,
nutritional or diet supplements and exercise or fitness information.

The Pew organization calls these computer users "health seekers" and found
that half of them say they would turn first to the Internet for their next
health question.

Susannah Fox, an associate director with Pew, said in general these "worried
well" were more likely to use search engines than go to a particular
health-related Web site and that most thought they were getting useful
information online.

"What we find is very often people are using the Internet to prepare for
doctors' appointments as well as to recover from doctors' appointments," Fox
said. "It's very often a rushed interaction. Sometimes a stressful
interaction. The Internet always has time to answer your questions."

Jackie Comp, a 45-year-old New Rochelle resident, could be described as a
health seeker. She turns to the Internet to research information on medical
conditions that affect her family and friends, sort out conflicting advice
and become better educated.

"It's not always possible to do a brain drain on your doctor for all of the
information and then to retain it," said Comp, who works in sales. "You're
often trying to absorb what they're saying. It's hard to remember. So it's a
great way to go back and really increase my understanding of what they're
trying to communicate to me."

Comp has also attempted to self-diagnose, recently telling her doctor she
had either walking pneumonia or pleurisy. She said her doctor, Dr. Steven
Meixler of the Westchester Medical Group in Harrison, took this attempt at
practicing medicine with good humor. She said she would never trade him in
for a Web M.D.

"The Internet doesn't replace the warm, comforting care and assurances you
get from your doctor," Comp said.

Patients are not always wrong when they self-diagnose.

Occasionally, women who have trouble losing weight and have a family history
of an underactive thyroid will come in wanting to be tested for the problem,
and will indeed be diagnosed with it, said Dr. Kamini Shreedhar, an
endocrinologist with Diabetes and Endocrinology Consultants of West Nyack.

But some who self-diagnose are wrong, Shreedhar said.

"People who have difficulty losing weight are convinced that they have a
slow thyroid," Shreedhar said. "Thyroid symptoms are usually very, very
nonspecific, like difficulty losing weight, fatigue, aches and pains,
constipation, hair loss. Then there are articles online telling patients
that they can have a normal thyroid blood test and still have a thyroid
problem. That is not true."

There are obvious dangers of self-diagnosis. Researching your symptoms may
lead you to believe, for instance, that your chest pain is muscle strain
rather than a heart attack.

"A lot of times people are doing this without getting any type of medical
backup and may become overconcerned about something that isn't real or
underconcerned about something that they really should be attending to,"
said Dr. William Frishman, the director of medicine at Westchester Medical
Center in Valhalla.

Frishman, who is also chairman of medicine at New York Medical College in
Valhalla, said medical students learn how to talk to their patients about
information in medical journals. But they do not cover how to handle a
patient who comes in with bad information.

"We talk about the angry patient, the sad patient," he said. "But not the
misinformed patient. I think there has to be attention to that."

The Web, of course, provides fertile ground for those diagnosed with
hypochondria, a medical condition in which people focus on their perceived
ill health.

Perhaps surprisingly, Dr. Fredric Neuman, director of the anxiety and phobia
center at White Plains Hospital Center, encourages people to read more about
their health, not less.

Neuman counsels those with health anxiety to read in depth about a condition
as long as they go to a reliable source. That way, he said, they will
realize that they do not actually have the symptoms of the particular

"The more information they have, usually the less they worry," Neuman said.
"But not initially. Initially whenever people read about anything it sounds
like them."



Top-ranked health sites

The Consumer Health WebWatch, a joint project of Consumer Reports WebWatch
and the Health Improvement Institute, rated the top 20 most heavily used
health Web sites. Those that received excellent ratings in the 2005 report

www.WebMd.com <http://www.webmd.com/>

www.NIH.gov <http://www.nih.gov/>

www.MayoClinic.com <http://www.mayoclinic.com/>

www.MedicineNet.com <http://www.medicinenet.com/>

www.KidsHealth.org <http://www.kidshealth.org/>

www.Medscape.com <http://www.medscape.com/>

The full list of sites is at www.healthratings.org.
Received on Mon Jun 26 20:40:39 2006

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