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Strong People

Diagnosis Surfing

How to use online medical resources wisely

If you were a patient of Dr. Gregory House, you wouldnít tell him youíd researched your symptoms on the Internet. House, the lead character on the TV show of the same name, would toss his stethoscope at you, proclaim that you are now a doctor, and summarily walk out of his office.

But in the world beyond the television screen, many physicians have come to recognize the value of their patientsí forays into cyberspace. These days, the Internet and live medical care can be judiciously combined to get you better results than either could provide alone.

For Diana C., the Internet has been a lifesaver. The morning after she awoke to find a bat in her room, she noticed marks on her shoulder. When they reddened and became itchy, she searched online and discovered that a bat bite can become fatal if not treated within 48 hours because bats carry rabies. Yet after Diana raced to the hospital, the nurse washed her wounds for just 30 seconds, not the five minutes recommended. One of the doctors told her she had up to a week to get her first rabies shot. Diana realized that she knew more about bat bites than anyone on her case. Only through her own vigilant efforts did she receive the care she required.

Similarly, the health-care system failed to identify the illness that plagued Jason D.ís young son. The boy, who would cough all night, seemed fine at his medical appointments. Through the Internet, Jason diagnosed his sonís asthma; he then requested tests from his sonís doctor that confirmed the diagnosis.

And Saul C. is indebted to an online symptom checker. It advised him to seek immediate medical attention when, several days into a cold, his leg began to swell up and hurt. He did, despite his fear that the doctor would chastise him for being overweight, and was diagnosed with cellulitis, an infection that can rapidly turn life-threatening if not treated.

Although the Internet can be a useful screening tool, itís no substitute for a good diagnostician. Doctors notice symptoms you might not, order tests, and expertly consider an abundance of possible diagnoses. But itís undeniable that some doctors may have little experience with particular diseases, and when thatís the case, Internet research can be invaluableóas it was for Diana C. Moreover, a patientís most telltale symptoms canít always be counted on to manifest themselves in the doctorís office, as Jason D. learned.

The Internet offers immediacy, a big advantage at night or on the weekend. It also offers anonymity, which is helpful when a symptom seems too embarrassing to discuss with your doctor. So by all means use the Internet the next time you have a health concern. Just remember:

If something looks too good to be true, it probably is. If miracle cures existed, everyone would know about them, including your doctor. Make sure the information on a website is from a reliable source, such as the National Institutes of Health, the Centers for Disease Control and Prevention, the Mayo Clinic, or the Alzheimerís Association. The HONcode (www.hon.ch) is the only seal indicating that a health site meets a standard of conduct, but it is not widely used.

Information should be current. Advances in medical science are frequent.

A nice-looking website is not necessarily one with high-quality information. Be wary of sites with a hidden or not-so-hidden agenda, such as some of those sponsored by pharmaceutical firms or makers of herbal supplements.

Your peers in online health communities are not doctors. Within these forums, people often offer advice based on their experiences. But you have to consider how seriously to take some of what you read. Membersí profiles might help. For example, in Weight Watchersí thriving communities, the starting, current, and goal weight for a given member will tell you if he or she has successfully lost weight.

Above all, seek professional treatment immediately if a website recommends it, or if you arenít getting better. Talk to your doctor about what you find online. In fact, if you receive a new diagnosis from your doctor, ask for websites where you can learn more about your condition. Chances are, youíll come away with some good recommendations.

Guest columnist LISA NEAL GUALTIERI is an adjunct clinical professor in the Program in Health Communication at Tufts University School of Medicine, where she teaches a course on online consumer health. She holds a Ph.D. in computer science from Harvard University.

  © 2008 Tufts University Tufts Publications, 80 George St., Medford, MA 02155