Who is Dr. Google and Is It Trustworthy ?

By Marilyn L. Pinsky

 

Many of us when we have medical questions go on the internet and Google the problem. In this interview, we will discuss the pros and cons of Dr. Google with someone who has both the clinical background and the technical skills to help us think it through.

Cheryl Brandi holds a Doctor of Nursing Science degree, is a whole health educator and lifestyle medicine professional who is passionate about helping people make sound healthcare choices by becoming informed consumers. She spent more than 50 years serving in multiple nursing roles, which included a 23-year active-duty Navy nurse career. Following retirement as a nurse practitioner in 2020, she shifted her focus exclusively to holistic health promotion and disease prevention through group education and individualized health coaching.

Here’s a summary of a recent conversation I had with her:

Q: Cheryl, what led you to focus on holistic health education?

A: I got interested in the topics of prevention and stress management when I experienced, as a clinician in our health care system, that we have too little time to give patients information that includes prevention and health promotion, not just the treatment. So people seek out their own answers and turn to the internet as a source of information. If so, they need to know how to do it smartly.

Q: There is so much health information on the internet, often giving conflicting advice and sometimes even conflicting with your doctor’s advice. How do you know you’re getting information you can trust rather than from someone who has an ax to grind or is selling a product or just wants clicks to attract advertisers?

A: The goal is finding information that you’re comfortable in applying to your own situation and allows you to make your own informed choices. And I know how difficult this is becoming. Some of our national government standards are either vague or in conflict with professional medical standards. I think searching for information that is based on years of research and solid clinical data is important.

Therefore, I recommend also going to professional sites for the most unbiased information, such as The American Academy of Family Physicians or the American Geriatric Society, for example. Other good sources are The American Cancer Society, The American Heart Association, The American Diabetes Association, etc.

Q: Aren’t those professional sites only for doctors and other medical practitioners who belong to those associations?

A: No, you don’t have to be a doctor, nurse practitioner or  physician assistant to get on medical sites; there is often a section that patients can access for information. For example, AAFP has a link called familydoctor.org and the AGS has a link to healthinaging.org, a good site for seniors. These are geared to the lay person.

Q: Where else do you go for the latest information?

A: These are the sites I search through:

Both the Mayo Clinic and the Cleveland Clinic are private, not-for-profits and operate trusted health portals that are easy to use.

The National Institute of Health runs the Medline Plus site, probably one of the best sites with a huge amount of information for patients and it is easy to use.

I  do take a look at other government sites such as the Centers for Disease Control site. The VA has very useful information for patients and is open to anyone, not just veterans.

Then I also look at data from other countries to get a global perspective from a number of different sources. Both Australian and Canadian medical sites can be easily found online. I feel they are based on solid research and clinical data.

In looking at any article or website, I evaluate the credibility of the report. Is it peer-reviewed, meaning that a panel of medical experts have reviewed the material prior to publication? Are there clinical studies to support the conclusions? What are the credentials of the authors, are they respected in their field? For websites, when was the last update? A good website will be continuously being updated.  If you have a concern about the website, is there a means of communicating with the website administrator? Who sponsors the site?

Q: Switching gears, let’s talk about ChatGPT and other AI apps who certainly sound intelligent.

A: They will give you some basic info but don’t use it in place of health care. These apps function from algorithms based on a large population of people with a condition, but they don’t know the specifics of the individual with the issue. So if you’re using it to help guide you, be very cautious when evaluating the responses as it doesn’t know your personal history. Mistakes have been made. Some diagnoses can be missed.

What is important in using those tools, is knowing how to ask the question to get the answer you want. With ChatGPT or any website, the more specific you can be will produce a better answer. Instead of just asking “I need information on cancer,” ask “I need information on stage 4 colon cancer in a 75-year-old diabetic male.” Then take that answer and refine it even further to get the information you want.

Look at it as a useful tool but not the final word. A downside can be finding information saying you have some terrible disease and that alone creates stress until you can get to a doctor to get it checked out.

Where it can be helpful is with self-management after a medical diagnosis. Usually when leaving the doctor’s office or the emergency room, by the time we get home we have forgotten half of what we were told to do for follow-up care. Usually we are handed sheets of papers that are either too hard to read or so general that they’re not helpful to your situation. AI or medical websites can help supply useful information for self-care.

Q: What do you think about symptom checkers?

A: Symptom checkers, like Mayo Clinic’s Symptom Checker, have value but only to a certain degree. They are just a way to get a sense when something’s happening and you’re not sure if you should worry about it or not. How urgently should you seek treatment? Do you have fever, chills, headaches? Is it a cold or a flu and are the responses different? Should I go to the ER? What if I’m having trouble breathing? Consider symptom checkers as a general guide when you don’t know how serious something could be.

For example, blood in the stool. It could be very serious or something simple. The symptom checker will help to guide you with questions like how much bleeding, how much pain? It can help you decide if you need immediate care.

Q: With all of this information out there, how do we best communicate with our doctors without sounding like we’re instant medical experts?

A: I suggest making notes before you see your doctor that you can give them or ask questions from. Use a format called OPQRST as a way of making the most of the time you have with your provider.

Describing symptoms:

O-onset. When did it start.

P-provocation/palliation. What makes it worse, what makes it better.

Q-quality. Example: if pain, is it sharp or dull.

R– region of symptom.

R-radiating out from a site or running down leg, arm, etc.

S-severity. Example: Worst headache ever or a 2 on a 10-point scale.

T-time. How long it lasts, comes and goes or always there.

And finally. You have to be your own advocate. It is hard for your provider to pull everything together as we get older and have more conditions. Keeping your own medical file is best and you should carry it with you from doctor to doctor. Don’t trust that your information was sent from provider to provider. Before you leave, ask the office to print out your last report for you. You could put it on a thumb drive, bring paper copies of your results or send via a patient portal to your next doctor.