The doctor in the search engine
With the vast sea of information now available in our mobile phones and computers through the Internet, more and more people are going online to help them interpret their symptoms and find remedies for their diseases. Studies abroad suggest that up to 80 percent of patients go to the Internet after consulting a doctor, and the number of visitors in local health websites suggest a similar trend in the Philippines. For instance, in Kalusugan.PH, the Tagalog-language health website that I maintain, we get over 10,000 visitors—presumably most of them Filipinos—every day.
As in any new technological development, there are positives and negatives to consider. Here are suggestions on how we can benefit from health information on the Internet, and how we can avoid its pitfalls.
First, we need to have an open mind for what the Internet can offer healthcare. Given cultural barriers (i.e., the patient is too shy) and time constraints (i.e., the doctor is too busy), many patients leave their doctor’s clinic with questions unvoiced and unanswered. The Internet can fill this void by providing answers to the many questions they have about treatment (i.e., When do I take my antibiotics, before or after meals?) and about their diseases in general (What is the cause of diabetes? Will my children be at risk?). The Internet also offers practical health information, like how to conduct a pregnancy test, or how to enroll in PhilHealth.
The anonymity of an Internet search makes it suitable for people who are looking for answers to questions they are too embarrassed to pose, whether to their doctors or even to their loved ones. In Kalusugan.PH, the most frequent question we receive is: Paano ko malalaman kung ako’y buntis (How do I know if I’m pregnant)? Next to that are questions about sexually-transmitted diseases, hemorrhoids, infertility and many others that are similarly sensitive. On the other hand, what about wellness? We go to doctors whenever there’s something wrong in our bodies, but where do we go to learn about maintaining our good health? For many, the Internet is the place to learn about healthy eating and healthy living.
Second, however, we must be critical of the information we get from the Internet. Not everything in the Internet, no matter how well-written, no matter how scientific-sounding, and no matter how laced with statistics, is true. You can end up convinced that soy milk causes cancer, or just as convinced that it is the healthiest drink ever. We must also recognize that the way we phrase our search queries determines the results we get. Google “herbal remedy for breast cancer” and you will find herbal remedies—even if none of them is proven to work. “Best drug for hypertension” will yield results, but there is no such thing! The Internet is geared toward generalizations, but in medicine this is fundamentally problematic because every person is unique and generalizations do not always apply.
Moreover, most health websites come from the United States and other countries from the global North. Understandably, they cater to audiences that are different from our own. It is unlikely, for instance, that the “ten healthiest foods” listed in the Mayo Clinic website will include malunggay, its sterling qualities notwithstanding. They might also recommend diagnostic tools or treatments that are not available, or not practical, in the Philippines.
Finally, we must use online health information with caution. The Internet has made it easier for patients to self-medicate, and given the laxity of our pharmaceutical laws, it is easy to procure prescription-only medicines from drugstores. But self-medication is fraught with risks. Drugs can damage your kidneys and liver, worsen existing conditions, or cause unwanted side effects. Quite literally, they are not to be taken lightly.
Also, there is an opportunity cost in treatment. Failure to avail yourself of proven treatment in favor of those being offered in the Internet can have grave consequences when, by the time you realize that the disease is worsening, it’s too late to benefit from a treatment that would have cured you had you availed yourself of it early on. Many cancers, for instance, are treatable with high success rates in early stages, but they become harder to treat as the disease progresses.
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Doctors and patients alike should take advantage of the availability of health information online. Healthcare providers should take the Internet as a challenge to be open, nonjudgmental, informative, and reassuring to their patients, mindful that the resort to the Internet for health information is, at least in part, symptomatic of a failure of the healthcare system to inform, educate, and build trust with patients.
On the other hand, patients should recognize that what doctors offer is not just information. The task of doctors is to integrate bodies of knowledge with their knowledge of the body, coming up with diagnosis and treatment based on a thorough examination of the patient, as well as an empathic ear to his or her feelings, concerns, and hopes, using years of clinical experience. Doctors make mistakes, of course, but they do learn from these. Indeed, they get better at understanding your condition—and your body—as you build a relationship with them, but this requires openness, trust and a little patience from both sides.
When it comes to health and illness, it is good to have a lot of online information by your side. But there are things that “the doctor in the search engine” cannot provide.
Dr. Gideon Lasco is a graduate of the University of the Philippines College of Medicine and a mountaineer. He is working on his PhD in medical anthropology in Amsterdam.
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