My Love/Hate Relationship with the Internet

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I have been practicing as an ob/gyn physician both in the years preceding and following the debut of the internet. Patients are now more educated about their health care – in both positive and not so positive ways. It seems that women in particular are drawn to the internet to search their symptoms and/or available treatments. While this can mean that there is much less education that needs to be done about the basic female anatomy and menstrual cycle, it can also translate into much longer discussions about the prevalence of diseases, a patient’s own personal risk, tests for both diagnosis and treatment and finally, refuting what some internet expert has to say about the medical condition in question.

One of my least favorite opening statements from a patient is, “I googled my symptoms and this is what the internet said I might have and these are tests that need to be done”. The majority of the time, the internet has diagnosed some awful disease process and the patient will not be happy until every test has been done to rule out the diagnosis. In my business, ovarian cancer is the diagnosis that populates most every search for midlife female problems, fatigue, weight gain, nausea and abdominal pain. Following the death of Gilda Radner from ovarian cancer, there have been periodic email blitzes encouraging every woman with any of the above symptoms to demand a blood test (Ca 125). Unfortunately, the test is neither sensitive or specific and is rarely used for diagnosis. Many patients are still not happy after I have spent 20 minutes with them detailing why I do not think they have whatever it is they think they have and still demand that further testing be done.

If you are a Hollywood celebrity, why is it that you can be more of a medical expert than the physician who has spent at least 12 years of their life training for the profession? I have given up trying to challenge what some of these celebrities embrace as there can be no common sense reasoning with some of these personal opinions and experiences. Most of the time celebrity recommendations can be harmless, unless you consider the loss of money, but sometimes it can cause people to refuse reasonable treatment for life threatening conditions. Dr Oz is a physician and better looking than most of us, but a cardiothoracic surgeon by training, not a ob/gyn who cares for women day in and day out. I doubt that he has seen patients in the office recently and I am sure that he profits from many of the treatments he endorses.

Pregnant patients are particularly susceptible to surfing the web for dangers to their unborn fetus. 9 months is a long time to stay vigilant on a daily basis against most of these harmless dangers (ie luncheon meat, sleeping on your back, cat litter box). There are even phone apps that update you each month of pregnancy about what your newest concern should be!

The internet can also be a helpful tool when I am talking to patients. I am able to access a wide array of pictures to inform patients better than I can with words. Our office has compiled many of our handouts in pdf form that are available on our webpage, so they can never be lost and are accessible from anywhere. I can direct patients to specific sites that I have researched and know are credible. As I often hear from my kids, “This is a first world problem”. I agree, but wish there were some sort of rating system on credibility for internet health sites.

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