By | April 21, 2011

Reposted from Scott Adams blog @ Dilbert.com (original link)

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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