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Some of you have heard this story, but I will reiterate to make a larger point. I had a mysterious voice problem that I accurately diagnosed using Google after several doctors were baffled. I woke up one day thinking my voice problem might be related in some way to my hand problem - a writer's cramp called focal dystonia. So I Googled "voice dystonia" and up popped a link to a video of a person speaking with exactly the same speech defect I had at the time, something called Spasmodic Dysphonia. That diagnosis was later confirmed, and I tried the recommended treatment of Botox shots to the vocal cords, which had limited success in my case. And I did voice therapy which helped some, but I was far from fixed.

About a year ago I started using Google Alerts to tell me whenever someone mentioned Dilbert, me, or anything about Spasmodic Dysphonia on the Internet. About six months ago I got an alert with a link to an obscure medical publication with a report about an even more obscure surgical procedure for fixing spasmodic dysphonia. I took that information to my doctor, who referred me to an expert at Stanford University, who referred me to an expert surgeon at UCLA. Long story short, the operation I read about wasn't as promising as the article suggested, but the final surgeon in my travels had his own version of surgery that had a good track record. I tried it, and now my voice is normal. I never would have found that path without Google Alerts.

I've used the Internet dozens of times to diagnose various minor medical problems, or to find out what things are dangerous or not. It made me wonder how far the Dr. Google trend can go, and what impact that can have on society's medical costs.

Obviously there are plenty of examples where seeing a trained doctor is going to give a better result than using your own flawed judgment plus the Internet. Let's agree those cases are many and somewhat obvious. But the real question is whether there are just as many or more cases where using the Internet instead of a doctor gives you a BETTER result.

Let's say for the sake of argument that we're not talking about emergency room or trauma situations where a doctor is obviously the best solution. I'm talking about all the trips to see the doctor where you essentially say, "Something hurts. What is my problem? Do you have a pill for that?"

In those cases let's say we can break it down into two general categories: common and uncommon problems.

With the uncommon problems, such as my spasmodic dysphonia, I have to wonder if Google (or WebMD, etc.) can do a better job than a doctor, if not now then maybe in the near future. If you could call up videos of people with identical symptoms, couldn't you diagnose most of your own problems?

For example, are you any worse than your doctor at looking at High Definition pictures of a skin problem and comparing it to your own skin problem?

My guess is that the Internet could equal your doctor in diagnosing uncommon problems. WebMD for example asks a bunch of diagnostic questions and narrows down your symptoms just as a doctor would. That system will only improve over time.

Common problems are even easier to diagnose, give or take someone looking in your ear or down your throat. And I'm imagining someday you can buy a home kit that takes a picture down those orifices and puts it on your computer for easy comparison to stock medical pictures.

This leaves us with the issue of dispensing meds. Your first reaction is that obviously you want a doctor to do that because otherwise people will abuse the system or diagnose something deadly for themselves. But perhaps there is another way to approach this safely.

Suppose as a patient you simply needed to answer a series of questions on your other health issues and medications to determine if a drug is safe for you. Once you establish your medical database, you have fewer questions the next time you need a prescription. The database plus your pharmacist would be enough to keep you from killing yourself accidentally. In some cases you still need a doctor if the meds are especially risky, but that would be rare.

You still have the risk of a patient requesting things he doesn't need. The pharmacist plus your database can flag most of that abuse. And perhaps you could have a system where a doctor "approves" patients to handle their own prescriptions if they appear to be responsible, up to a certain age.

I don't have the details worked out, but I think Google will be your new doctor in some fashion.

 
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Dec 8, 2008
Something is broken on the blog - the links at the bottom of the google-doctor post aren't going to the entry's comments. I had to finagle my way in by going to the next entry's comments then altering the number in the URL.

Now in actual comment on the entry - it's not just for very specific and unusual conditions that Google/WebMD does a better job, and it's not just when you yourself are the sufferer. I have successfully diagnosed a friend, via the internet, down to two 'maybe' diagnoses, one 'probably' (Lupus!). They went to five doctors trying to get a diagnosis after my attempt - two of them said my two 'maybe', and the other three said Lupus. So in that case, WebMD and a second-hand symptom description does a diagnostic job equal to five doctors.

In cases of myself, WebMD has done a better job than doctors; one doctor's "dermatitis" ("here, have some steroid-cream") was later better diagnosed as scabies ("pharmacist, sell me this over-the-counter goo please") by a computer, while *two* doctors' (the first one called in the second) "an infection" ("here, have some antibiotics") was later better diagnosed as poison ivy ("pharmacist, sell me this over-the-counter goo please") by WebMD. Now, while it is the case that I had more information than the doctors in that second case (I knew my boots had been in the woods), I knew absolutely nothing about poison ivy, being from England, certainly didn't know its oil could soak through soft leather boots, and surely the fact that I had this information shouldn't have led to a more accurate diagnosis given that it's not like I *withheld* the information from the doctors, they just didn't ask at all. (Also, what sort of doctor just goes "an infection", on *both feet*, without looking for any sort of cause? A crap one is the answer.)

In conclusion, my experiences with internet-doctor versus real-doctor are such that I now won't ever go to a real doctor for a diagnosis - I would only go to request scans that require machines I don't have, if that's a necessary part of a diagnostic procedure. I have similar doubts about mainstream cures versus crazy cures found on the internet.
 
 
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Dec 6, 2008
Oh my...apparently the Dilbert Blog does not like contractions. :)

Sarah
 
 
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Dec 6, 2008
@ Shamlam:

While I find your post to be amusing, I have to respectfully disagree.

I am a third year law student who was also a former "lawyer basher" (so please do not think I am posting this to defend my future profession, necessarily). Now that I have been through three-quarters of the training required to be a lawyer (I am going part time, thus the four years instead of three; it's like pulling a Band-Aid off of Sasquatch VEEEEERY slowly), I have a much broader understanding of the profession. That being said, I have to admit that the first profession I thought of after medicine when I read this post was lawyering. Then I rethought and figured that that would be a bad idea.

There are many different substantive and procedural rules that vary from state to state that it would be next to impossible to incorporate them all into a search that would do the average person’s legal problem justice. Additionally, there are ethical rules (yes, lawyers have ethical rules; please quell your cacophony of laughter) that lawyers have to follow when it comes to aiding in the unauthorized practice of law. There are also rules about practicing outside of the state in which you have been admitted to practice. What I'm getting at is if this were to become an idea that someone (or many "someones") wanted to get off of the ground, there would have to be at least one lawyer admitted to every state that would be willing to contribute the rubrics that the "quizzes" or search engines would have to use in order to get a cognizable result for any layperson who was seeking an answer. Either that, or laypeople would be putting this information out there and chaos would ensue when the laypeople who used Google, Esq. went into court pro se and tried to use the information they found on the internet on the poor unsuspecting court systems.

While I think that Google, Esq. could be a good resource for VERY general searches on general subjects of law, I think it would be disastrous if it were to be used more specifically than that.

On a personal note to Mr. Adams: I don’t get to read for pleasure very much considering I work full time and go to school part time at night, but I always make a point to read the Dilbert blog (even if it is in class…shhhh) because it truly does lighten the load. Thanks for that, Mr. Adams.

Yours,
Sarah Steele
Future Esquire
 
 
Dec 6, 2008
THX-1138 had a splendid vision of what a future automated medical system might look like. *smirk*

One thing is "obvious", google has access to much more information than any one person/doctor can acquire/retain. Works (worked) great for very specific, correct diagnosis', but more general/vague symptoms (e.g. "fatigue") are much more likely to send folks down some unproductive paths.
 
 
Dec 6, 2008
Scott- This is Dr Ross, cardiologist. I have been working on new solutions for neuro disorders including dystonia for 5 yrs. I quite agree that Dr Google is very helpful to the discriminating reader; and Google Alerts is like having a personal reseach assistant on-call 24/7. I found your Blog via my Google Alert.

Dr Google not only helps pts know more about their options, it helps innovator-wanna-be's like me help debunk some of the dogma, find and cultivate new ideas, integrate them, and help to move fields of medical therapeutics forward. As you know, most medical practitioners are quite conservative -minded and risk averse. Additionally, the volume of medical information is too great for the increasingly time-constrained clinician. These and other factors co-conspire to stifle innovation and progressive ideas.

I am glad you are bringing Dr Google into the public's consciousness. As patients continue their transformation into 'medical consumers' the Dr Googles of the world will play an increasingly important role. Thank you.
 
 
Dec 5, 2008
The first step would be making Google the primary source of legal council, and I think that would fly in the face of their "Don't be evil." thing.
 
 
 
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