Miércoles 6 de Junio de 2007, Ip nº 194

Visits to doctors who are not in, ever
Por Michelle Slatalla

MY children have in recent weeks decided that they have leprosy, irritable bowel syndrome and Lyme disease.

“I’m contagious,” my 9-year-old said, looking up from the laptop on which she had just typed her symptoms one morning last week. “I shouldn’t go to school with strip throat.”

“It’s strep throat,” I said, not looking up from my breakfast. “And you don’t have it. So go get dressed.”

In the old days, children dreaded a visit to the pediatrician, where getting a shot was always a possibility. But now that Dr. Google makes house calls, mine spend hours online typing queries into search boxes to investigate symptoms — “Mom, does this image of ringworm look like the thing on my leg?” — before printing out proof that they should not be required to walk the dog in the cold.

Nobody is really sick at my house; the suspected ringworm turned out to be nothing more than an elastic mark from a sock. But my children definitely are exhibiting the symptoms of a new syndrome.

By taking their symptoms online without the benefit of stethoscopes, much less medical degrees, they are following in the footsteps of plenty of grown-ups. As a host of recent studies show, a growing number of people — as many as 40 percent of the 39,000 adults surveyed for a 2006 Consumer Reports study — are researching their medical conditions online.

But those people are getting mixed results. According to the same survey, 41 percent of primary-care physicians reported that patients arrived in their office armed with bad information they found on the Internet. The American Medical Association, which warns that Web sites with inaccurate information may confuse people or even endanger their health, cautions patients not to consult Dr. Google instead of a real M.D.

I admit that even I have been known to type in “scratchy throat” and “rash on arm” and then seconds later, after scanning “Results 1-10 of about 21,500,” declare that I need immediate antibiotic treatment. Are my children headed for the same fate?

To find out, I phoned Dr. J. James Rohack, an A.M.A. board member who practices in Temple, Tex.

“Strip throat, that’s a good one,” Dr. Rohack said. “It reminds me of patients who would come in saying they thought they had ‘sick as hell anemia,’ instead of sickle cell anemia.”

“My daughter will probably try to use that one next to try to get out of doing homework,” I said.

“Kids certainly are Internet savvy, so I wouldn’t expect her to turn to the Encyclopedia Britannica anymore to find out what’s going on,” Dr. Rohack said. “But one thing I would teach her is to appreciate that while you can find all the information online, you can’t just accept everything you find as fact. You want her doing research at places where the information she’s getting is really based on science.”

He suggested steering online investigators away from general search sites in favor of trustworthy sources, like Medem.com. The A.M.A. helped develop the site, which has a free online medical library. (The children’s health section, by the way, has articles on topics like ear infections written by members of the American Academy of Pediatrics.)

Other free sites — including Mayoclinic.com, CDC.gov (the Centers for Disease Control and Prevention), NIH.gov (the National Institutes of Health) and Bestbuydrugs.org (Consumers Union) — also offer exhaustive troves of health and drug information. And Consumers Union, the publisher of Consumer Reports, also has a subscription site at Medicalguide.org that ranks treatments based on clinical trial results and costs subscribers $19 a year or $4.95 a month.

Patients should not skip going to the doctor in favor of sleuthing online, though. “I encourage my patients to get more medical information to be a better patient,” Dr. Rohack said. “But I also think you need help wading through all that information, and that continues to be the higher role of doctors.”

But the easy lure of Dr. Google’s keyword search box may be impossible to overcome, especially among younger Internet users.

“Now more than ever, search engines are absolutely central to how people search,” said Susannah Fox, associate director at the Pew Internet and American Life Project, which last year published a report about online health searches. “In earlier years, we found there were more people who had health sites bookmarked. But now we find that bookmarks are for older people. The rest of the population really does trust the algorithms of search engines to return useful results.”

There’s a reason for that. Unlike people 65 and older who immigrated online after spending their youths thumbing through reference books, today’s children are digital natives who are fluent in the language of online searches, said Marc Prensky, an educational consultant and the author of “Don’t Bother Me Mom — I’m Learning!” (Paragon House, 2006).

“Kids can just find stuff faster than we can, and know how to put it together,” Mr. Prensky said. “I heard a story from a guy at Microsoft who told me his kid’s grandmother had cancer and was going in for surgery, and the kid said, ‘Grandma, I’ve done some research and I hope you’re having this operation with Dr. X because I’ve gone online and I know his success rate is much better.’ ”

As today’s children age, they will increasingly rely on collaborating online with peers as a tool to weed out erroneous information, Mr. Prensky predicted.

“Our generation holds information that might be useful one day close to the chest, but kids share it like crazy,” he said, adding that in the future, “Kids will look at a situation and say, ‘This is a problem for 20 people to figure out,’ or ‘This is a problem that will take 10 people,’ and they’ll break it down and share it.”

So if I ever get ringworm, I told him, at least my daughter will spot it right away and get me in for treatment. “Ringworm may be unlikely, but the idea is these kids will be ready to spot, deal with, share information, as opposed to people who don’t know how to find out anything online,” Mr. Prensky said.

Until then? The next time my daughter comes down with a case of strip throat, I may suggest to her that Dr. Google’s treatment of choice is a shot.


  24/05/2007. The New York Times.