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"Am I a hypochondriac?"

10/9/2013

2 Comments

 
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There's one question I get asked a lot:

"I research my health problems on the Internet. Am I a hypochondriac?"

First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them out. I firmly belief that no complaint is illegitimate.

Nor, for that matter, is looking stuff up on the Internet a problem. Given that the advice proferred by doctors is most often not consonant with the scientific evidence (to quote this much-cited paper, "Even those physicians who are most enthusiastic about EBM rely more on traditional information sources than EBM-related sources "), I doubt that seeking information on the Internet is any worse. (Of course, there is already a considerable literature on the topic.) Nor do I know of evidence that seeking health information on the Internet increases worry, another common concern mentioned to me.

I think the relationship between physical symptoms and worry actually go in another direction, at least as I see it. A subset of those who have common physical complaints sometimes have a lot of them, and with some frequency these are due to undiagnosed anxiety disorders or other psychiatric ailments - which often go untreated.

In short: physical complaints are never to be dismissed, no matter what their cause, and having recourse to publicly available information is not to be looked down on either.


2 Comments
Lori Schneider link
10/17/2013 10:18:57 am

As a patient that would never have been properly diagnosed w/o tireless research in medical journals and "doctors-only" sites, I believe that the presence of such info should motivate doctors to remain on top of their game. No more slacking off and trying to get by on what was covered in an hour during their first yr in medical school.
Patients should be encouraged NOT to use commercial sites that spread info not grounded in current science (WebMD, Mercola, Oz, Facebook, etc.).
Many patients are actually well-educated and aren't looking up info out of fear or hypochondria, but b/c doctors are NOT considering all options and thinking that hoof beats automatically means "horse." It doesn't. It is shocking that such an adage still exists.
In short, it is due to the closed-mindedness and refusal to think outside the box by many physicians - we simply need scientific backup to prove there is something wrong because we are tired of being ignored.

Reply
Zack Berger link
10/17/2013 11:31:38 am

Thanks for your comment. You are saying, if I understand correctly, that a lot of patients don't look up information on line because they have misplaced confidence in their doctors? That could well be, but th confidence in providers is generally at an ebb, it seems.

What should someone do in that situation, you think? How did you finally start learning for yourself?

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    The author of Talking To Your Doctor and Making Sense of Medicine blogs about the books, shared decision making, doctor-patient communication, and the redeemable imperfections of healthcare.

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