Dot-Com Diagnosis: How to Use the Internet to Get the Best Health Advice (Without Totally Freaking Yourself Out)

by Lisa Jones

It starts innocently. The big toe on your right foot doesn’t feel quite right—it’s kind of numb, a little tingly. Maybe I just tied my running shoes too tight at the gym, you think. It’s probably nothing.

But you’re curious. So soon you’re typing “numbness” and “tingly toe” into a search engine. And in no time you’re clicking on links about “Morton’s neuroma,” “transient ischemic attack (mini-stroke)” and “vitamin B deficiency.” Oh, no, you think. It’s a mini-stroke. You’re sure of it.

Sound familiar?

A 2008 study by Microsoft Research showed that Web search engines have the potential to cause an unfounded escalation of medical concerns, a.k.a. cyberchondria. This is because the Internet is designed for finding relevance—not capturing diagnostic factors like disease probability—so search engines link rare serious disorders and common symptoms (such as brain tumors and headaches), according to Eric Horvitz, one of the study researchers.

But if you look online for health information—61 percent of American adults do, according to a June report from the Pew Internet & American Life Project—you don’t have to end up in panic mode. Use these tips to navigate through the mass of health and medical information without losing your perspective:

Skip the search engines.

Begin researching your ailment on a health-information site you know is legitimate rather than simply Googling. In addition to the potential for cyberchondria, the latter might lead you to a site designed to pitch one treatment or drug. Experts say the best sites are those affiliated with national organizations and associations, the federal government, or certain not-for-profit groups and medical centers. (See our list of five great health sites.)

Check the site's credentials on the "about us" and "editorial policy" pages. Pay attention to things on the site like: Are the articles being edited or vetted by health professionals? Is the information recent and labeled with the date when it was written or updated? (Good signs.) Are you being asked for personal information? Does editorial content reference products advertised on the site? Are quizzes leading you to one brand-name treatment? (Bad signs.)

“You have to be a cyberskeptic, basically,” says Naomi Miller, manager of consumer health information for the National Library of Medicine, which is part of the National Institutes of Health and publishes the consumer Web site MedlinePlus. “Don’t rely on just one. See if you go to a number of sites, do they all say the same thing, or is this the only one that’s saying 'This is our miracle cure'?”



Make sure any online diagnostic tools you use are speaking directly to you and your situation. “In most cases, good reliable sites will tell you, for a symptom, what are the most frequent producers of that symptom, and what are the most likely in your particular demographic group,” says Roger Harms, M.D., medical editor in chief of MayoClinic.com. “If you’re a 25-year-old woman, it’s a lot different than if you’re a 65-year-old man with the same abdominal pain.”

Don't spend too much time checking your symptoms against a hypothetical list, and don't let those lists dictate your symptoms. (Maybe my ears really are ringing!) "That energy and focus are better spent making a list of your symptoms, trying to construct a timeline of them, and really fully characterizing those symptoms in terms of what happened first, what helped, and what didn’t help,” says Benjamin Ansell, M.D., a preventive cardiovascular specialist and director of the UCLA Executive Health Program. That will save time in an appointment and give your physician a broader view of what it is you’re experiencing. Keep in mind, the one or two symptoms you’re worried about may not be the most important things that will interest your doctor.

Resist the urge to self-diagnose.

The Web is great for expanding your health literacy and giving you an idea of what your symptoms might mean, but it’s not a replacement for your health-care provider.

You—having experienced a symptom maybe only once or twice—are not nearly as qualified to evaluate its cause as a health-care professional who sees the same symptom all the time (and has years of education and training). The good news: chances are, all that training will lead your doctor to a cooler head. “Believe that it’s more likely to be one of the common things, and don’t freak yourself out with the oddball thing that happens to one in 100,000 in the population,” says Harms.

Don't use the Net to connect your symptoms with a disease that you happen to know about anecdotally. “Literally, that happens almost every day in the practice,” says Ansell. “I saw a young gal who had mono, and she was worried because one of her best friends had Hodgkin’s and the symptoms are similar ... both mono and Hodgkin’s come up on a symptom checker.” In such cases it’s easy for you not to see the full picture and to jump to the wrong conclusion.

Step away from the discussion boards and disease blogs ... for now.

If you haven’t been professionally diagnosed with a specific disease or condition, browsing patient discussion groups, forums, or blogs on the topic also won’t be a lot of help and will likely bring more worry than relief.

However, these sources can be helpful once you are diagnosed. “They’re a very valuable way to connect with people who share a common diagnosis, and they can provide excellent emotional support and tips on managing a disease from people who’ve been there,” says Miller.

Keep in mind that these are places to get advice for managing life with a disease—not to get specific medical advice. The patients posting could have false information or a worst-case scenario for the disease that is very different from your situation.

Give your doctor the bullet-points version.

As long as you’re not going in with your own diagnosis and demanding a specific drug, a good doctor will be happy to discuss concerns related to your online research, according to Harms, but not if she's overwhelmed by data. “Summarize the information you want to discuss in a few short sentences or bullet points,” suggests Miller. “And only share information from reliable Web sites.”
 
If you have a doctor who answers patient e-mails, you could also e-mail something you found and ask if it’s a valid source of information. “It’s probably not appropriate to ask, outside a doctor’s visit, for a lengthy explanation,” says Ansell. “But getting a quick thumbs up or thumbs down from a physician about a particular site could be very, very helpful.”

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