Stop using Google instead of going to a doctor

Blame it on Google. The bizarre tale of an IIT graduate who claimed that a Google search for symptoms of AIDS convinced him that he and his family were infected with the HIV virus and prompted a suicide pact, made news last week. A 39-year-old Praveen Manwar reportedly set his wife and daughters ablaze in a car, but lived to tell this story to the disbelieving police.

However far-fetched this story may seem, it certainly highlight the perils of self-diagnosis from Google. “Self-diagnosis may lead to grief,” reiterates Dr Prahlad K Sethi, author of Medical Second Opinion, a patient’s perspective on how, when and why a second opinion is necessary in medical matters. Though medical etiquette is often set up against a second opinion, many situations call for this, especially in today’s scenario of dubious medical ethics. Award-winning neurologist and founder of the Brain Care Foundation of India, Dr Sethi sheds light on the matter. He suggests that we begin by reflecting upon our motives for doctor shopping. Is it because our primary doctor's diagnosis was doubtful and presumptive? Or is it because we want to avoid the treatment recommended? Apart from these reasons, he writes about other more subtle factors that drive people to getting a medical second opinion, such as the ominous social implications of a diagnosis: A young woman engaged to be married, who is told she may develop multiple sclerosis, will search for a doctor to disprove this diagnosis, just as a person with an incurable disease wants a medico who will offer him a miraculous cure. Relatives who do doctor-rounds to get a certification of “disease” for the sake of legal cases are also common, such as a husband who wants a certification of insanity for his wife, to provide him grounds for divorce.

Numerous social and cultural factors influence medical decision-making among Indians. Fear of surgery prompts a majority of desis to search for a doctor who suggests physiotherapy instead. This may be wise sometimes, considering how knife-happy the medical establishment has become. Reliance on technology may have become the norm for most doctors, but this isn’t necessarily a good thing, Sethi says, reminding us that 90 per cent of medical diagnoses are made on the basis of a physical examination and questions. Investigations should only be used to prove or disprove a diagnosis. Though the notion of a GP (general physician) or family doctor may have become outdated, the author advises his readers to hang on to theirs. “If you have a good GP, do not lose him, give him the respect he deserves and do not take undue advantage,” he advises.

Sometimes a second opinion can affect optimal treatment and prognosis. When a person with an incurable disease being managed effectively with pills decides to go to another doctor who offers a cure, and ends up in a worse condition, for instance. “Medicine is, at its core, an uncertain science. Every doctor makes mistakes in diagnosis and treatment,” said Dr J Groopman, in his New York Times bestseller How Doctors Think. Groopman is one of many doctor writers in the US who have played an important role in bridging the doctor-patient communication gap, by enabling a broader understanding of doctors’ motives and behaviour.

Though patient voices are barely audible here and rights are also in their infancy, books like Medical Second Opinion are a step in the right direction. Doctors like Sethi who are effective communicators can help the general public to understand and negotiate the maze of diagnostic and treatment options out there. Making medical choices in the era of super speciality can be overwhelming and sometimes necessitates taking doctors off the pedestal and assuming a more proactive role in decision-making.