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Mar 27, 2019 10:16AM
Mar 27, 2019 12:47PM
Another Google success story!
I recall as a child riding my bicycle to a library in the next town over to review a 10 year old edition of Encyclopedia Britannica for a 6th grade book report so to me, the value of internet research to be able to gather recent information quickly and put it to use in a timely manner and these were the obvious benefit in your case and many others here on the forum. Well done.
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It always brakes my heart when I hear about patients who have succumbed to what I refer to as 'Google Paralysis' a kind of panic disorder that in its worse form, will actually delay patients seeing their doctor for fear of finding out they have the rarest of incurable medical conditions for their age and gender just because a 19 year old on-line-magazine intern had to beat a deadline for posting their article on "The 7 Deadliest Medical Conditions That Have No Symptoms" and doesn't fully explain how unusual it would be to come down with malaria in Cleveland without ever having left the country.
Since joining this forum, I have read too many posts that describe the worst kind of mental anguish that members have endured all because of an article they have read online and these posts seem to pop up every day (see my previous Google-related rant).
The basic problem with this situation IMHO is also the basic problem of practicing medicine in any specialty in a litigious society like ours: Physicians can never say "You don't have that" even if its true without solid proof and in this country that proof costs a few billion dollars a year nationwide in the form of imaging and laboratory tests.
In the pre-technology days of the 50's and 60's my father would see patients who came to him complaining of symptoms like headache, fever, stomach pain, chest pain, leg cramps etc. and after taking a complete history and performing a complete physical exam decisions were made and actions were taken based on the doctor's training and experience, along with a few lab tests and simple x-rays. By now you are all familiar with the med school saying "when you hear hoofbeats think horses not zebra" and this was the acceptable approach at the time and there was an 'acceptable' miss-rate.
In my era, CT and MRI were introduced. During these new 'high tech" times of increased diagnostic accuracy, patients still presented with a set of symptoms, but now after the history and physical you were sent for a CAT scan 'just to make sure'. This became a fairly routine defensive practice since no one wants to hear an attorney call and say "Mrs Jones is dead, why didn't you get a CAT scan?" The phrase had to be modified to "when you hear hoofbeats think horses but first scan for zebras".
Recently my daughter has introduced me to the concept of 'Cyberchondria', basically a Google-induced hypochondria (the old term for Health Anxiety). She tells me that after a thourough internet search, some patients now present with a chief complaint of "I'm pretty sure I have Rare Zebra Disease #2". So now no matter how reflexively you want to say "You don't have that" a full work up must ensue or both of you will face the consequences of missing that unlikely diagnosis. Now this by no means applies to all patients, but this small subset of patients is large enough to be written about in peer reviewed medical journals (Here is a list of those articles).
Not to make light of this condition, but this brings to mind the scene from Woody Allen's movie Hannah and her Sisters where Woody reminds his co-worker Julie Kavner of his recent health scare involving a large irregular black spot he found on his back and she reminds him "It was on your shirt!".
I think it was Freud that said "Sometimes a rash is just a rash" to which the Internet now replies "...except when its IBC" and this has become the problem we need to solve.
Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com