It’s Monday 4 September 2017
Welcome to Spring, or if you’re in the Northern Hemisphere, Autumn.
Thank you for listening and thank you for watching Medical Fun Facts
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Last week I asked for feedback. I didn’t get much, but that’s okay. A friend on Twitter suggested gunt and for those who are not familiar with that word, you can either look up Urban Dictionary or think FUSA, or fatty upper pubic area.
Rather than share experiences with gunt, I opened the Google search engine and typed in “famous medical people last name starts with G.”
Up popped Joseph Mortimer Granville. Granville lived from 1833 to 1900. He was English and he is best known as the inventor of the electric vibrator.
He invented it not as a device for sexual pleasure but for the relief of muscle aches. In fact, it’s said he eschewed what he called the misuse of his invention for the treatment of what was then called hysteria or a wandering womb under the belief at the time that doctor induced paroxysm could cure insomnia, irritability, nervousness, or “excessive moisture inside the vagina”.
Anyway, I’m not sure that Granville and electric vibrators are necessarily a good topic for discussion on Medical Fun Facts. Instead, the letter G could also represent Google or Dr Google. I’m not a fan of the term “Dr Google”. It’s become popular and made more popular by journalists looking for a catchy vacuous phrase. It’s become common for people to open the Google search engine and type in various symptoms they may or may not be suffering. The search engine’s algorithms are so good that within fractions of a second a long list of possible diagnoses is provided. In some situations, if the inquiry was made intelligently, the list could function as a provisional diagnosis along with a differential diagnoses list too. The difficulty is that medicine is more than symptoms. Signs that a doctor elicits are important, medical, family and cultural history are important. We should never forget a patient’s sexual and travel history either. A good medical practitioner will always run through her or his mind a broad classification starting with infectious, neoplastic, endocrine, psychiatric, neurological, immunological, and hæmatological systems. I would argue, that physical examination is vital in the vast majority of situations.
While using a search engine may help a patient get some idea, I think the best way to use a search engine like Google is after seeing the doctor and learning more about the diagnosis. I know many people will disagree and feel that I’m disempowering them, I’m not. I’m looking at this from a medical perspective. Quite often when a patient presents with a large amount of researched information, an internal bias may have formed, it’s really important that such biases are recognised and accounted for in the assessment and diagnostic process. This is especially true if the patient has explored online forums where people share stories of their illnesses. This is known as confirmation bias.
There will always be stories of patients being more educated than their doctors and the fact that if it were not for their own painstaking research, the illness may never have been diagnosed. I’m not discounting those experiences for a second. On the other end, there are patients convinced they have an illness only to realise after a sign has been elicited or a pathology test has been performed, that the symptoms fit something else entirely. Medical practitioners are also real time risk managers, we have to be able to instantly weigh up the product of likelihood and consequence, we have to determine if a risk is acceptable or not and if not, we need a risk treatment to ameliorate the risk. The likelihood component of risk, with risk being the product of likelihood and consequence, is something that we learn in medical school and hone throughout our careers. As much as I love the Gregory House approach, in truth, common things are common and the best-placed person to understand likelihood is usually a well read and experienced medical practitioner rather than a search engine like Google. That said, I’m sure the software engineers are working on clinical support algorithms to rival the best clinicians.
So I have some questions for listeners.
- Have you used a search engine like Google to make a self-diagnosis?
- Did this approach help?
- Would you recommend Google before or after seeing your general practitioner or family physician?
- Do you think I’m too old fashioned and paternalistic in my thinking or am I on the money?
Please leave your answers in the comments section of the show notes or on the Facebook page or on YouTube.
If you have any questions or comments please let me know. If I’ve said anything incorrect I welcome correction. I’ll catch you next week for episode 83. Something beginning with the letter H. Send me suggestions.
Thank you, and good night.