When Patients Consult Dr. Google

“I have a food allergy.”

“I have a parasite.”

“I have ‘leaky gut’.”

“I have esophageal spasm.”

These are examples of speculative diagnoses offered to me by patients.  It is natural in the era of the internet, with artificial intelligence (AI) looming, that patients will search for explanatory diagnoses for their symptoms. Who knows?  In time, and sooner than we think, AI’s performance may exceed that of human physicians, as well as other human endeavors.  At that time, AI may be preparing my weekly blog posts as it interferes and takes over the rest of my life. I won’t succumb willingly to this omnipresent and overpowering force, but I acknowledge that it will not be a fair fight.

Most often, patient offered diagnoses are wrong, even though an internet search seems to have nailed the diagnosis precisely.  I have fever, fatigue, muscle aches, headaches and digestive issues.  Google let me straight to malaria!  How did my doctor miss this?

Dr. Google will see you now!

Let me state plainly that there are times that a patient’s suggestion is correct, or at least leads me toward a more fruitful investigative path that I had not considered.  Patients, like physicians, rely upon their experience.  For instance, a patient who has had multiple episodes of diverticulitis, who calls me with the exact same symptoms is likely correct when requesting diverticulitis treatment from me.

True food allergy is very rare.  It is possible, of course, that patients wondering if they are ‘allergic’ to wheat may have an intolerance instead.  Physicians like me test for parasites with some regularity.  Ask your own doctor when was the last time he or she has actually found one.  It’s a very rare event.

Esophageal spasm is very rare.  I can’t recall the last time I’ve seen a true case of this.  Yet, this diagnosis is often erroneously assigned to patients who have no ready explanation for their chest pain.  When in doubt, blame the esophagus.

Leaky gut is an entity that has been popularized in the alternative medical community.  Conventional digestive specialists  are not acquainted with high quality medical evidence of this condition.

Patients want firm diagnoses explaining what ails them.  We physicians are charged with this task.  At times, we are unable to deliver on this mission.

Self-diagnosis by patients, aided by friends and loved ones, can lead to false pathways and dead ends, even if they sound plausible.  However, just because if makes sense, doesn’t mean it’s sensible.  Think of colonic hydrotherapy, a series of treatments to clean out the body of injurious toxins that are alleged to be responsible for various manners of distress.  If only there were high quality supportive medical evidence…

I welcome patients bringing me their thoughts and research findings to their visits.  While their hypotheses may be incorrect, good conversations invariably follow.  And it communicates to me that these patients are empowered and are advocating for themselves, which contributes to ore robust doctor-patient relationship and better outcomes. 

And, as I've commented above, the patient may be right and deserves a fair hearing.

Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address at this link to receive my posts directly to your inbox.