Dr. Google & The Future of Medical Care

Talk to (almost) any medical professional about Googling health issues and you’re going to get a response along the lines of, “Ugh, I really hate when people diagnose themselves with Dr. Google!” I was once that person, myself.

When I joined the medical field a little over a decade ago, I was a bright eyed 19 year old with big ideas and opinions about all kinds of stuff, including how medicine should work.

Before becoming a medical assistant, I didn’t have much experience with the medical field. I had been to see a few doctors over the years for random things, such as the constant tremors in my hands and acute chest pain (both of which were dismissed as anxiety), but for the most part we just didn’t do doctors.

The first doctor I worked for was great. She cared about her patients and took the time to build a relationship with them. And at that time, she only charged $150 for new self-pay patients and $50 for follow ups (unheard of even then). She really loved her job and was great at it. Her patients loved her because she spent time with them and actually listened to what they had to say.

The Changes

As time went on, I worked with more doctors and slowly began questioning my decision to do clinical work. Eventually, working with doctors pushed me into more clerical roles; I got tired of being treated like an idiot and, at times, cussed at or threatened. It became easier to deal with the paperwork than to do what I loved, which was help people. In all honesty, I truly miss clinical work.

Then, my health began its descent into what it is now. I found myself not only working with asshole doctors, but being treated by them, too. My problems were either considered insignificant or too complex, or straight up nonexistent by doctor after doctor.

I began to notice how offices were set up to get as many patients in and out as quickly as possible. This worsened significantly with the widespread introduction and eventual mandated use of electronic medical records.

Now, EHR as a concept is great; patients get instant access to their records and all of their medical team can access all of their information across the country. However, because we allow capitalism to control our healthcare, competing EHR companies created their own systems and those systems don’t speak to each other, meaning all of the “great” things about it don’t actually exist.

Communication Breakdown

No longer were doctors able to have face to face conversations with their patients; instead they were forced to sit at a computer and input arbitrary information to keep insurers happy.

For some doctors, this didn’t change much – they never really had good bedside manner to begin with. But for the ones who did care about their patients and who took time to get to know them, the stress became insurmountable. Many left their practices to join larger groups so that they didn’t have to deal with the headache anymore. It’s a lot easier to join a big practice, in which someone else handles the insurance aspects, than it is to try to do it yourself, on top of seeing patients. Some stopped practicing entirely

Partially because they now had additional costs due to the implementation of EHR, both groups – independent doctors who owned their practice and big corporations – began seeing more patients each day. New patient appointment slots went from 45 – 60 minutes down to 30 minutes and the slots for established patients became 15 minutes instead of 30; neither one allowing nearly enough time to effectively communicate with patients or build a rapport – especially since the majority of the visit is spent with the doctor clicking away at a computer instead of actively listening.

This obviously makes both the patient and the provider feel rushed, leading to a lack of complete information being transmitted. The patient feels like they can only give tidbits of information (instead of listing all symptoms, for example, they only list the ‘important’ ones, which means the doctor doesn’t get a complete picture), and the doctor – because they are human – seeks only the quickest, easiest answer, not necessarily the correct one. Complications equal time that they don’t have.

The Results

Slowly but surely I saw as patients (myself included) lost trust in their medical providers. I saw from both sides how medicine was changing – and not for the better. Not only was I being treated like cattle at my appointments, but I was working in offices where we were forced to treat others like cattle.

During this time, the internet was getting bigger and better and easier to access. Patients realized that they could just Google things instead of trying to make an appointment with a doctor who wouldn’t listen to them, anyway.

For those of us with rare diseases, we found validation in online forums and Facebook groups. The symptoms that were brushed off by rushed doctors began to make sense to us. Finally, we felt heard!

Sadly, this just deepened the communication gap between the patient and the medical provider. Because we are all only human, offense was taken on both sides. Patients who felt they had finally found answers were offended by the providers further dismissal, and doctors who felt like all of their education and experience was being discounted were offended by their patients “playing doctor”. Instead of coming together as a team, it pushed them further apart.

What’s Next?

Artificial intelligence has already come to the medical field, in the form of telemedicine, especially, and it will only continue to infiltrate it. We have created AI algorithms that can read chest x-rays and diagnose as well, if not better, than trained radiologists.

Now, some say that it can never replace human providers because AI cannot empathize or create relationships, but the majority of providers aren’t doing that anymore, anyway. Whether because of stress, heavy patient loads or burn-out, providers aren’t who they used to be.

My brother and sister’s pediatrician was my mom’s pediatrician. She could call him any time of day with any problem and he would answer. He would often call her to check on them. This was in the 80’s – it’s not something that happens anymore.

Final Thoughts

Obviously all medical providers aren’t bad and all information on Google isn’t accurate. I’ve worked with wonderful doctors and I’ve given myself unnecessary panic attacks by Googling symptoms. This is a nuanced issue that will take a nuanced approach to solve.

Providers are burning out because they are overworked and overwhelmed. What makes us think they have the time or energy to research complex medical cases, when they’re seeing 30+ patients a day? They don’t! I’m not bashing them – most of them get into the field to help people and slowly but surely have their souls sucked out.

But who or what fills that void? Dr. Google.

When you’re dealing with debilitating symptoms that are constantly brushed off by physicians, yet you find entire communities of people dealing with the same symptoms, you’re going to go with them. When you’re told over and over that your problems are minor or just in your head, you’re not going to seek out answers from the people telling you that – you’re going to find others with the same issue and try what they try.

If doctors want patients to stop seeing “Dr. Google”, they’re going to have to make fundamental changes in how they practice medicine.

AI will eventually take over medicine, and it’s already starting. From telemedicine to Dr. Google, the medical field is changing. It’s just a matter of who will fight it kicking and screaming and who will embrace it.

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