Don't You Hate Dr. Google?

When I was in med school, there was an internet, of sorts, but most research involved going to the medical library and digging through paper journals. Our education focused on memorization—in fact, pre-medical education selects very strongly for students with excellent memories over just about anything else.

And an excellent memory is important in medicine. But in an age where the entire corpus of medical knowledge can be found on a computer smaller than a deck of cards in your lab coat pocket, it’s more important to know how to find and use information. If you’ve been taught how to find and interpret the enormous and complex body of medical knowledge, memorization becomes somewhat less crucial.

On a recent episode of The Pitt a critically ill child lay on a gurney with a breathing tube down his throat. When the doctors outlined their plan to save him, the parents objected, rapidly thumbing their phone keypads. It may seem like an extreme example of consulting “Dr. Google”, but if you ask any doctor, I’m pretty sure they’ll find the scene realistic and uncomfortably familiar.

Medical knowledge is now available to my patients as much as it is to me (almost—to read most journal articles I need to get through paywalls using my relationship to my hospital and university). But just because someone can read about how to build an airplane doesn’t mean you’d want to fly in it.

Patients often say to me, “I know you must hate it when patients google stuff but…”.

I don’t hate it at all, as long as we both know that this is a great starting point. The more a patient is involved in their own healthcare, the better. But we all need to be wise enough to know what we don’t know. I happen to know a lot about medicine (and canoeing), but not much else. No one is an expert in everything.

We tend to think of ourselves as experts on our own bodies because we are. But one thing most of us are not is objective. And being an expert on the subjective experience of being a person with a human body is different than being an expert on human anatomy, physiology, and pathology. Just as I cannot presume to be an expert on how a patient feels, a patient should not (for their own sake) presume to be an expert on the science that can explain why they feel that way. Conversely, doctors must be attentive to a patient’s subjective experience. Just because a patient doesn’t talk like a doctor doesn’t mean they are ignorant—it means you as a doctor have to do your job. You have to take what the patient gives you and give them back advice informed by their experience and your expertise—and hopefully compassion.

Medicine has a lot of pitfalls that aren’t obvious if you haven’t studied them. As we’ve talked about in earlier pieces, medical science is tricky and often counter-intuitive. Just because something makes perfect logical sense and also explains your symptoms, that doesn’t make it correct. It is true in any field that reading up on something does not make you an expert (just ask anyone who has tried to fix their own plumbing on a weekend). In medicine, assuming you know more than you do can get people killed.

Of course it’s not just laypeople who make this mistake. There are plenty of doctors out there who, because they are experts in one area of medicine, think they are experts in all of medicine. They aren’t. They are dangerous.

But unlike a bad doctor, a patient who thinks that googling can take the place of a decade of training followed by years of experience isn’t a danger to others, only to themself. But they can bring to the doctor something the doctor can never know—what it feels like to be them. A patient’s own research can, at its best, help a patient and doctor communicate and understand one another better.

My suggestion is always to read up as much as you feel comfortable with, but to listen to experts. If you don’t trust one expert, get a second opinion. Get as many opinions as you need, but remember that you can always find someone to give you the opinion you want. It’s also important to get the opinion you need.

So, no, I don’t hate Dr. Google. I invite the collaboration engendered by the availability of so much knowledge to everyone. Hopefully we as doctors can earn the trust of our patients, the kind of trust that allows them to want to collaborate on their own health, as equals. We are both experts, but in different fields, and cannot succeed without each others’ input.

Stay well.

-pal