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Online Medical Searches By Dr Zach Levine, ER physician MUHC

BT Montreal | posted Tuesday, Oct 10th, 2017

Online Medical Searches

By Dr Zach Levine, ER physician MUHC

People search the web about health

In a pew study over one year:

59% of people looked up health info

35% used the internet to try and diagnose their ailment

When people look up their symptoms they get the correct diagnosis 34% of the time

Medical questions:

— Most common online general health questions

·         Is bronchitis contagious?

·         Is pneumonia contagious?

·         How much water should I drink?

·         How many calories should I eat?

·         What is lupus?

·         How far along am I?

·         When do you ovulate?

·         What is gluten?

·         How long does the flu last?

·         Men search about urinary and erectile issues

·         Questions about non-western medicine

— Most common online symptom questions (mayo precedings/13)

Flu

Gallbladder infection

Measles

Listeria

Sinus Infection

Gastritis

Anxiety Attack

H. Pylori infection

Heat Stroke

Lactose intolerance

— Most commonly searched diseases

Diabetes

Depression

Anxiety

Hemorrhoid

Yeast infection

Lupus

Shingles

Psoriasis

Schizophrenia

Lyme disease

Vs.

Why people actually present to to the doctor

1. Skin disorders, including cysts, acne and dermatitis.

2. Joint disorders, including osteoarthritis.

3. Back problems.

4. Cholesterol problems.

5. Upper respiratory conditions.

6. Anxiety, bipolar disorder and depression.

7. Chronic neurologic disorders.

8. High blood pressure.

9. Headaches and migraines.

10. Diabetes.

And

What actually kills people (biggest killers in Canada)

Cancer

Heart disease

Stroke

Chronic lung disease

Trauma

Diabetes

Alzheimer’s disease

Influenza and pneumonia

Suicide

Kidney disease

Analysis:

1. Why the differences between what people Google and what they ask their doctor?

Embarrassment, forget, don’t have doctor, and they try to get a diagnosis online.  Also, they ask what’s on their mind at the time.  More likely to look up calories, water intake online.

2. Why the difference between what people as their doctor and what the doctor addresses?

Doctors focus on the big killers, ie cardiovascular disease, cancer risk factors and screening.  Patients focus on what’s ailing them and what worries them

3. Men vs women internet health – women search more, more well-informed, search for their families.  Women are often the reason men finally come to get things checed out

4. Increasing mental health concerns — unclear if incidence is going up but people are more aware of it, and look it up online

5. Mind body health relationship, integrative health — people understand that the mind and body are intimately connected, and that mental health is important to physical health.  And people like non-medicinal and natural treatments (but make sure there’s evidence)

6. The main point — you are not alone.  Millions have already searched that.  You can and should talk to your doctor about it.

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_Details below_______________________________________________________________________________

Not much relationship between the top killers and what people search.

People search what they really want to know and what scares but may be embarrassed or afraid to ask.  People aren’t that scared of the top killers but they want to feel better (mental health), they look how to treat themselves (hemorrhoids, yeast infections).  And some things may have subtle symptoms — eg/Lyme disease.

Categories of questions (gomerblog):

1.    Too embarrassed to ask doctor — gonorrhea from toilet seat, anal sex

2.    Worries — is this cancer?

3.    Google second opinion – weight loss without exercise or diet, avoiding flu without the shot, lyme disease

Increasing searches about mental health issues point to both increasing awareness and maybe incidence (conflicting studies).  There is still stigma so people should talk about it, and doctors should ask about it.

Doctors and patients agendas often aren’t the same — docs may focus on the cardiovascular killers while patients are worried about their health now.

Lupus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

(incidence about 1/1000 people, more in women and people of colour)

Lyme disease – spread by tick bite

Stage 1 – circular rash (approximately 50% get it), flulike illness

Stage 2 – headaches, joint pains,

Stage 3 – problems with memory mood sleep, fatigue, arthritis

Increasing in QC — 32 cases in 2011, about 200 this year (esp in eastern townships and monteregie, southwest of montreal – not many deer on the island of Montreal

Gender differences men v women internet health searches.  2015 study by Bidmon or Terlutter

RESULTS:

Women were more engaged in using the Internet for health-related information searching. Women used the Internet for health-related information searches to a higher degree for social motives and enjoyment and they judged the usability of the Internet medium and of the information gained by health information searches higher than men did. Women had a more positive attitude toward Web 2.0 than men did, but perceived themselves as less digitally competent. Women had a higher health and nutrition awareness and a greater reluctance to make use of medical support, as well as a higher personal disposition of being well-informed as a patient. Men may be more open toward the virtual patient-physician relationship.

CONCLUSIONS:

Women have a stronger social motive for and experience greater enjoyment in health-related information searches, explained by social role interpretations, suggesting these needs should be met when offering health-related information on the Internet. This may be interesting for governmental bodies as well as for the insurance and the pharmaceutical industries. Furthermore, women may be more easily convinced by health awareness campaigns and are, therefore, the primary target group for them. Men are more open to engaging in a virtual relationship with the GP; therefore, they could be the primary target group for additional online services offered by GPs. There were several areas for GPs to reinforce the virtual patient-physician relationship: the fixing of personal appointments, referral to other doctors, writing prescriptions, and discussions of normal test results and doctor’s notes/certificates of health.

Mind and body are intimately intertwined

Integrative medicine (UCI new $200B grant) – uses both western and complementary tx

Complementary – in addition to western

Alternative – instead of western

complementary/alternative tx — natural products, yoga, chiropractic and osteopathic manipulation, meditation, and massage therapy, acupuncture, hypnotherapy, homeopathy, naturopathy

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