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Doctors use the Internet, and patients can, too. But be wary of trying to diagnose yourself using the Web.
AS A PRIMARY-CARE
I know this may be surprising, since most docs are likely to seem a tad annoyed when you start an appointment off with "I read this online "
The Internet is both powerful and dangerous when used as a resource for information about health, wellness, diseases and treatments. So before you start surfing, let's make sure your board is ready to go.
Being "health literate" is what sets apart "good" patients from "bad." I have heard countless colleagues complain that the reason people don't get better is that they ignore a doctor's advice.
Why do people ignore medical advice? There can be many complex reasons, but one that is well researched is a phenomenon known as low health literacy.
I see this all the time in my practice: intelligent adults who do not know what medicines or doses they are taking, and also don't know the results of major tests or hospitalizations they have recently been subject to; details of important family history; or important preventive measures that are recommended to keep you healthy.
I do not judge, though. Health literacy is not systematically taught well-- high school health classes are a joke when we consider the breadth of what is involved in helping individuals become effective consumers of health care.
So what helps people become more health-literate? Often, people who have family members in health care learn that having a health advocate improves the care one receives. Others are self-motivated and read all about health from someone like Oprah's new BFF, Dr. Mehmet Oz. (His book, "You: The Smart Patient," is actually quite good.)
There is a high degree of personal responsibility in maintaining your health, and I think it is helpful to view your physician as your adviser and partner rather than a technician who will keep you rolling along without your effort. But do you know how to navigate the increasingly complex health care system? Do you know how to help your doctors take the best care of you?
Start with the basics. Here are some really important things you should be aware of:
Your past medical problems, current conditions, medications and doses
Whether you have had an allergic reaction to any previous drugs
The surgeries have you had in your lifetime
A clear sense of who your primary-care doctor is
Your upcoming appointments and tests
The ailments that are common in your family, especially your parents and siblings, along with what may have caused the death of your immediate family members.
Some find that keeping all of this information handy makes each doctor visit seem like smooth sailing.
After mastering the basics, it's time to take the next step.
You will get the most out of your encounters with doctors by communicating your symptoms accurately.
Doctors will use your description of symptoms and a physical exam to get them about 90 percent of the way to an accurate diagnosis. The X-rays and blood tests usually confirm a diagnosis, but will be directed only by your words.
My advice is to ask questions when you do not understand what a diagnosis means, or why tests are being ordered or medications prescribed. Ask about what to expect and how best to manage your health. Knowledge is what will help you manage your health.
INTERNET: FRIEND OR FOE?
While I said earlier that I encourage patients' self-directed Internet learning, indiscriminate use of the Web will drive even me nuts.
Your computer cannot diagnose you. Period. If you look up "headache, causes" not only will you probably soil yourself due to the myriad of life-threatening diagnostic possibilities, but you won't get any closer to an accurate answer.
Nothing will replace human beings when it comes to diagnosis, at least until "Star Trek" fantasies are realized with the invention of the handheld tricorder. Attempting to self-diagnose with the help of the World Wide Web can lead either to unnecessary panic or misplaced complacency, neither of which should seem acceptable to you.
However, the Internet is a great place to learn about what vaccines you should obtain and when (the Centers for Disease Control and Prevention, at cdc.gov, has great information on recommended vaccines).
The Internet also can inform you about the recommended screening and preventive tests that will keep you healthy (see the U.S. Department of Health and Human Services Web site, hhs.gov).
But most of all, the Internet can be a place to answer all of your questions about a given health condition you may have. Become an "expert" on your own health. If you are diagnosed with diabetes, hop online and learn all you can about diabetes. If your doctor diagnoses you with cancer, use the power of the Internet to educate yourself about it--this information will lead to new questions and less fear.
Better preparation will lead to more productive and fruitful encounters with the increasingly intimidating health care system.
Happy hunting to all my health-literate readers!hsph.harvard.edu/nutritionsource: a top source of nutritional information cdc.gov/vaccines: a good source of vaccine information medlineplus.gov or mayoclinc.com: detailed information on diseases
Dr. Christopher Lillis is an internist with Chancellor Internal Medicine in Fredericksburg. He can be reached
"Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."
--U.S. Department of Health and Human Services
In general, trust Web sites that end in .gov, .edu and .org (in that order) over any that end in .com or .net. This is not a perfect rule,
Beware of any sites that make a claim to miracle cures, or purport to have information "that your doctor won't share with you." I have met some questionable doctors in my day, but none who would intentionally withhold information from a patient that could alleviate pain and suffering.
--Dr. Christopher Lillis
Dr. Christopher Lillis is an internist with Chancellor Internal Medicine in Fredericksburg.