The ultimate test: Dr Google vs an actual doctor

YOU have a sore throat. It could be the start of a cold, or it could be that rare neck-eating cancerous parasite you’ve heard about. How do you find out? You ask Dr Google.

I do it. You do it. Sometimes even doctors do it. We all consult the internet when we want to know about our mysterious symptoms, and whether we’ll still be alive by lunchtime. It’s so much more convenient than making an appointment with a doctor, sitting in a germ-splattered waiting room and going through the rigmarole of describing your symptoms in actual words to an actual person. Ugh. What a hassle.

Clearly, the internet has transformed the way we approach so many of our problems. Whatever your particular issue, you can probably find a solution for it just by tapping a screen. The success of this wonderful world wide web is due to the fact that humans are inherently lazy. If there’s a faster, easier, more couch-centred way of doing things, we will do it. And health care is no different. But how good is online health care?

There are some promising online health care services available, like healthdirect.gov.au, an Australian government health services gateway, or internetdr.com.au, which provides discreet sexual health pathology testing via an email service. But how does internet health care information rate against seeing a three-dimensional, flesh-and-blood, university trained doctor?

I did a little experiment. I entered three symptoms into Google, one by one. For each symptom, I recorded the first three possible diagnoses that came up in my search results, regardless of where they came from. Then I compared those possible diagnoses with advice from a range of medical experts. I asked the doctors, “What would you ask the patient?”, “What tests would you do?” and “In your experience, what is the most common diagnosis for this symptom?”

SYMPTOM 1: THREE DAY HEADACHE

What Google suggested:

Brain tumour, aneurysm or migraine.

What the experts would ask:

What other symptoms do you have? What medications or alternative therapies do you use? Have you had a headache like this before? What’s your medical history?

What tests would an expert do?

Neurological tests for weakness or abnormal reflexes. Checking for fever and infections. Depending on medical history, CT or MRI scans.

Most common diagnosis:

Migraine or tension headache.

SYMPTOM 2: SWOLLEN ANKLES

What Google suggested:

Heart disease, kidney failure or liver failure.

What the experts would ask:

Have you injured your ankles recently? Do you have a history of heart disease or varicose veins? Is it worse at a certain time of day? What medications or alternative treatments do you use?

What tests would an expert do?

Listening to the heartbeat with a stethoscope and checking the pulse. Checking the legs for DVT. Checking lungs, skin and eyes for inflammation. If heart problems are suspected, further cardiac tests like an echocardiogram or electrocardiograph.

Most common diagnosis:

Varicose veins or build-up of fluid.

SYMPTOM 3: SHARP PAIN THE THE STOMACH

What Google suggested:

Appendicitis, pregnancy or gallstones.

What the experts would ask:

How long have you had the pain? Do you have any other symptoms? When is it worst? What have your bowel movements been like? What medications or alternative therapies do you use? What’s your diet like? What’s your medical history?

What tests would an expert do?

Feeling the abdomen. Listening for bowel sounds. If infection is suspected, a stool sample might be taken.

Most common diagnosis:

Gastro or constipation.

It’s clear to see that the kinds of questions and tests that medical experts employ to diagnose the cause of symptoms are detailed, complex, and rely on seeing, examining and listening to their patients.

Doctors often use a complex ‘symptom tree’ model to diagnose patients. Initial questions, tests and observations lead to secondary questions and tests, and so on until all but one diagnosis can be ruled out.

Internet-based health information can be valuable. But our health depends on so much more than what we can read and interpret online.

Dr Google is no substitute for thorough, face-to-face consultation with a qualified medical expert. How else will you know for sure you’re not pregnant with a liver-eating brain tumour?

Shelley Stocken is a freelance writer with a special interest in scepticism and rage-typing opinions on a coffee-stained keyboard. She tweets as @shellity.

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