Ask Dr. Hallberg: Cyberchondria - you may have it

About two-thirds of Americans have looked to the Internet for help in diagnosing medical symptoms or finding information about a specific disease, according to a study from the Pew Internet and American Life Project.

MPR's medical analyst Dr. Jon Hallberg discussed how Americans use of the Internet for medical issues is changing with Tom Crann of All Things Considered. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic.

An edited transcript of that discussion is below.

Tom Crann: How accurate can online diagnoses actually be, especially when it comes to a serious illness?

Jon Hallberg: It's really tricky, I think if someone has a very specific symptom or just a couple symptoms, a really bad sore throat with white spots on the tonsils and a fever, it's pretty easy to figure out that that's strep throat. There are a lot of programs that can help you figure that out. But if you have something like fatigue, for example, and you're just not feeling well, and you start to punch in your symptoms, those symptoms can be true with almost any disease you can think of and that's where people get into trouble.

Crann: How often in the clinic do you get someone who comes in who's anxious over something they have Googled?

Hallberg: The times being what they are, this happens quite a bit. I think I'm kind of lucky, I don't have my own patients who do this. But there certainly are times that people come in and they've done some digging and they're very anxious, and if I can't address their fears satisfactorily, it's a very poor visit that comes out of that.

Crann: We've talked about this phenomenon before, but I understand that things are changing on this front from a few years back when it was a fairly new thing to do.

Hallberg: I've noticed a couple different trends. On the one hand, I think we providers are actually embracing the internet in some ways. I'll have colleagues that will send people to watch, for example, on YouTube. How do you use a neti pot? Well, it's kind of hard to describe that, but if people can go and see it, that's actually a beneficial thing. There are some good ways of doing that and embracing the internet.

I've also found that people who've had certain diagnoses will go online and frankly they just can't read too much. They have a cancer, for example, they start to go down that path, and at some point, often within minutes, they decide, I just can't do this, because it's just too grim what I'm reading right now.

Crann: And it isn't in any way tailored to their situation in a way that consulting a doctor for a treatment plan might be, right?

Hallberg: In two cases I can think of recently, two people with very different cancers read stuff that just scared them. But, in fact, in both cases their outcomes will be much better than they ever would have imagined because they actually met with a specialist who told them that their circumstances were very unique.

Crann: This is an inevitable trend. More and more people are doing this on a regular basis, so how do you counsel patients in this regard if it's going to happen?

Hallberg: There are two things. On the one hand, if people are worried about symptoms and they plug things in and they're trying to figure out what they have, I think that's a very poor use of the internet. It's almost impossible to get an accurate diagnosis, so I really discourage people from doing that.

If you have a condition and you know what it is and you want to learn more about it, the Internet is wonderful for that. But I think you need to make sure you're going to a place that has good quality info, the Mayo Clinic website, Cleveland Clinic, the National Institute of Health has Medlineplus.gov. [Those are] great ways of vetting out some of that stuff. Those are the places I steer people to.

Crann: In the clinic has this changed, do you have to be more reassuring with people who really are anxious over what they've found?

Hallberg: Anxiety and health care have gone hand in hand forever. It's certainly been the case in my entire career, I think the internet has just been one more thing, for some people it might raise the anxiety, for other people it might diminish it a bit. I'm not sure I've seen a change one way or the other, but it's just one more thing that's out there that we didn't have 10 or 15 years ago that we have to deal with now.

Interview transcribed by Jon Collins, MPR reporter.

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