Dr Google: checking online health info

Remember the days of Dr Finlay’s Casebook with doctors the all-powerful keepers of almost everything we needed to know about our health? They seem a distant memory in a world where we’re just a click away from all the health advice we could seemingly need, 24/7, on the internet.

These days a visit to the doctor is as likely to begin with a Google symptom search as it is in the surgery waiting room.

Office for National Statistics figures show that almost half of Britons aged 55-64, and over a quarter of those over 65, regularly use the internet to look up their symptoms.

‘I’m well used to patients now arriving for their appointments laden down with health information hot off the internet,’ says GP Roger Henderson, who works in a surgery in Newport, Shropshire.

How to get the best from your GP appointment 

The benefits of online health information

Sites such as NHS Choices, which attracts more than 50 million visitors each month, Isabel and Patient, which use complex algorithms to match symptoms to conditions, contain detailed, reliable condition and treatment information on everything from diabetes to dementia. These websites can be invaluable for getting strong clues as to why you’re feeling ill, and whether your symptoms merit a 999 call, a visit to the GP or are just something you can sort out yourself.

The information can also enable you to ask the right questions at a doctor’s appointment and suggest conditions that may not immediately spring to mind. NHS Choices even provides the truth behind health-scare stories in the news – recently debunking reports of tight trousers causing nerve damage and Alzheimer’s being contagious. See more at the NHS’ Behind The Headlines page.

The web can be extremely helpful, too, in expanding on a diagnosis made by your doctor, finding out what’s involved in various tests (such as whether you need to fast beforehand), side effects from medication, and checking on doctors’ or other healthcare workers’ qualifications and expertise.

The drawbacks of online health information

But of course a ‘Dr Google’ consultation can bring many problems. The main one is to create unnecessary anxiety, as anyone who has hunched terrified over a screen in the wee small hours, convinced they are dying of some deadly disease, knows only too well.

Doctors increasingly use online symptom checkers themselves, but these are not always foolproof, particularly if you don’t know which ones to trust or how to interpret the information. In July 2015 a British Medical Journal (BMJ) study of 23 websites found they provided a correct diagnosis in just 34% of cases and appropriate advice on what to do next in anything from 33% to 78% of cases.

‘Anyone can put anything on the internet,’ says Dr Kristine Rasmussen, honorary researcher at Imperial College London’s eHealth Unit. ‘There’s no regulation of health websites or apps, which can make it difficult for patients to assess their validity.’

‘Using the internet to self-diagnose may result in delays in seeking medical help, out of fear of what the doctor may say, when in fact many symptoms have a simple explanation,’ adds Dr Rob Hicks, a GP in Kingston, southwest London.

So while the web can be a great resource, you need to know how to use it safely and confidently if you’re really going to help, not hinder, your GP.

Start with a trustworthy site

Rather than Googling symptoms, go to a well-established, evidence-based website

• NHS Choices nhs.uk is the NHS official website and the UK’s leading health website.

• Netdoctor netdoctor.co.uk has contributions from more than 250 leading British health professionals.

• Isabel isabelhealthcare.com is used by  professionals as well as members of the public.

• Patient patient.info is a leading independent website. It also runs the Isabel symptom checker.

• Boots WebMD webmd.boots.com includes material from authoritative sources.

• Major health charities, such as the British Heart Foundation bhf.org.uk and Cancer Research UK cancerresearchuk.org are good ports of call.

• For reliability, look for British government-backed websites ending in .gov.uk, university websites ending in .ac.uk and hospital sites in .nhs.uk.

• Some respected US organisations can also be informative. Try the Mayo Clinic mayoclinic.org and the National Institutes of Health nih.gov/health-information. Treatments and procedures on US websites, however, may not apply here.

Is it trying to sell you something?

If the site is run by a company that wants you to buy a drug or treatment, check with your GP first. And avoid websites that ask for money for advice.

Warning signs

A reliable website should look credible and sound professional – no spelling mistakes and sloppy grammar. Steer clear of sites that have no address, email, and/or telephone number in their ‘Contact’ section, but perhaps just a Webmaster email.

Is the site up to date?

Medical information changes fast. ‘Check content has been medically reviewed in the past two to three years,’ advises Dr Hicks. ‘If a website cites recent research, it’s usually more reliable than one that harks back to studies done decades ago.’ You should find these details at the bottom of the relevant page.

Beware weasel words

Avoid sites that woo with easy solutions or ‘miracle cures’. Use common sense when it comes to claims of solving medical problems with ‘one simple tip or trick’. If it seems too good to be true, it probably is.

And beware the use of words such as ‘Centre’ or ‘Foundation’ in the names of so-called research organisations, which can be meaningless and are there only to boost credibility, says Dr Henderson.

Your GP and PC in perfect harmony

Use online information to assist your GP’s expertise, not replace it

• If an authoritative website has suggested what your symptoms might be, mention it to your doctor as a rough guide. But avoid telling them definitively what your condition is or coming loaded with printed-off information. He or she needs to make a professional appraisal of your problem.

• Do ask if that nagging chest pain could be angina, say, if your doctor doesn’t mention it and you’re concerned. But bear in mind that although some diagnoses are easy to reach, many require further investigation and only your doctor has the tools and experience to do that.

• If you read online about a new development or treatment and want to know more, say so. If your GP is aware of it, they’ll be happy to tell you whether it applies to you. If not, they may refer you to a specialist.

• Once they have given you an expert diagnosis, your doctor will often be able to point you towards the best websites to learn more about your condition, how to manage it and possible side effects of treatment.

Check the five Ws

Whichever website you go to, it’s worth asking yourself the following questions:

Who is behind the site?

Why did they set it up?

Where is it based – the UK or elsewhere?

When was the content written?

What do they want you to do with the information provided?

(The ‘About’ section of a website should reveal the answers to most of these questions)

Look for the logos

The Information Standard Certified Member logo shows that the site has been through NHS England’s rigorous accreditation process.

And the Health on the Net Foundation code of conduct for medicine and health is an international ethical standard, approved by health professionals

Case Study: ‘Without Google, I’d have been much more anxious’

Marilyn Gray, a 60-year-old language teacher from Portslade, East Sussex, found the internet invaluable when she developed a little-known hormonal problem

‘I’m a runner and normally very active, so when my running times plummeted and I started feeling tired and lacklustre I knew something was wrong. A web search indicated I should go to the GP and she ran some blood tests that suggested hyperparathyroidism, most likely caused by a benign tumour on one of my parathyroid glands.

‘I hadn’t even heard of the parathyroid glands [in the neck] and, after just a five-minute slot with the GP, I was left with so many unanswered questions. But the internet proved very informative and reassuring. It told me that my symptoms were typical of over-production of the parathyroid hormone, which controls things such as calcium and vitamin D levels in the bones and blood. And when further tests revealed that I did indeed have a tumour and I was booked in for surgery, it told me what to expect, made me a lot less worried, and stopped me having to keep bothering my doctor with more and more questions. 

‘I had the operation in October and I’m back to my usual energetic self. Now I just have to build up my running times again!’

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