Posted on 6/16/2013

Written by Shari Flowers

Until recent years, it was standard practice for doctors to tell patients ‘what they needed to do.’ Patients were expected to accept this plan without question. Around the mid-eighties, the paradigm shifted. Doctors began to educate patients on their conditions and offer them a choice of treatments.  If patients wanted additional information about their conditions, their main source of information would be medical organizations such as the American Cancer Society or the American Heart Association.

Female doctor examining her patient.

Then came the internet, and along with it millions of sources of misleading (and often incorrect) information about medical conditions.  It has now become the norm for many patients to Google their symptoms or diagnoses and visit their physicians with strong opinions already formed.  While I am a strong believer in patient education and involvement, this trend is actually making it more difficult for physicians to guide their patients appropriately.  Here’s why you shouldn’t search your symptoms online before speaking with your doctor:

1) Extreme Cases. Many of the anecdotal reports submitted by patients or family members are not representative of the average person with a given condition.  People tend to write about extreme cases either of severe disease manifestations or of unusual recoveries with little or no medication (see #2).  The first case leads readers to feel undue anxiety about their condition, and can even trigger them to believe that they have the symptoms they read about. Patients may convince themselves that they have a disease, or that their disease is much worse than it actually is.  In these cases their next visit to the doctor is spent either struggling to convince the patient they do not have that disease, ordering unnecessary and often costly tests to rule out the disease, or in the worst cases escalating therapy when the patient has convinced their physician (and themselves) that they are experiencing the concerning symptoms they’ve read about.

2) Misleading Recovery Stories. Anecdotal reports claiming that serious diseases can be cured without medication can be quite dangerous.  Sure, there is the odd case of a patient whose cancer or lupus simply went into remission on its own. Maybe it was the new herbal remedy they tried.  Maybe it was just luck. Maybe they wrote their post before their disease came back more aggressively.  While there is definitely a time and place for holistic therapies in conjunction with medical treatment, the average patient with a malignancy or inflammatory disease will not get better without medical or surgical intervention. The same applies for many other diseases. The patient who stops his critical therapies without consulting his or her physician is putting himself at risk for disease flares and future medication resistance.

3) Information overload. For almost any combination of symptoms there are numerous possible explanations.  For example, if one Googles “headache and sore throat” results come up ranging from meningitis and HIV to allergies and the common cold, with everything in-between as well. It takes years of medical training and experience, as well as as proper diagnostic testing, to successfully differentiate between conditions with similar presentations.  It’s easy to panic and assume you have the most severe condition on the list.  It is equally easy to convince yourself that your symptoms can be explained by something harmless and do not need to be evaluated.  In either case, persistent or worrisome symptoms should be evaluated by your physician, not your computer.

If you want additional information about your medication conditions, the best thing to do is to ask your doctor for resources. I personally stock patient handouts for all of the major diseases I treat and medications I prescribe. If I do not have a specific handout for a patient,  I know where to find an appropriate one online. If your doctor subscribes to UpToDate (an evidence-based clinical decision support tool for physicians) they can access a large pool of excellent patient handouts.  If you have a diagnosis and still feel the need to look up information beyond what your doctor can provide you with then I would recommend visiting and searching under ‘diseases and conditions’. This site contains short but generally accurate disease information written for patients by physicians and other medical experts at the well-known Mayo Clinic.  All information is reported to be evidence-based and references are given for each article. This site won’t replace a doctor’s visit, but it can be a good source for supplementary information.

Save yourself and your doctor some time and anxiety by resisting the urge to self-diagnose online.

Flowers_S_18-1Meet Shari

Shari Flowers, MD practices rheumatology in Randolph, NJ.  She completed her rheumatology fellowship at Stanford University in Palo Alto, California, and her medical school and internal medicine residency at George Washington University in Washington DC.