When we were children, access to information was a privilege. I was lucky because at home they bought the twenty-odd volumes of some illustrated encyclopedia and with that I appeased my desire for knowledge. Later, I learned to navigate libraries. It took a lot of skill, a little luck and complicity with the librarian to find what you were looking for in them. Libraries had a peculiarity now being forgotten: the information one found was reliable. Since Gutenberg we were tamed to the idea that if someone had taken the trouble to write it down on paper, it was probably true. And if it was in a library, it had passed certain verification standards and there was no reason to doubt. Therefore, for centuries access to information was synonymous with education and the library was its temple.
With the rise of the Internet, the amount of information available has proliferated and access to it has become increasingly easier. There is no distance or time that separates us from any text ever written. Information in the palm of our hands. In an unexpected setback, the most prestigious scientific studies and conspiracy theories are now equally accessible in an infinite digital ocean. For those of us who are already of a certain age, and have experienced the transition from paper to clicks, it is not easy for us to assimilate that everything we read on the Internet is not necessarily true. It requires challenging centuries of information certainty around topics, about which until very recently people did not write in vain. Young digital natives have more information at their disposal than they could read. For them, the new badge of education is not access to information, but knowing how to recognize quality information and knowing what to do with it.
Currently there is so much information that, without the appropriate frame of reference, the avalanche of kilobytes available on the Internet buries us in misinformation. This will have happened to all of us when searching the Internet for information about our health. As if that were not enough, both on paper and online, medical terminology is what it is. Health has its own technical language and searching the internet can be like taking a lexicological dip. At the end of the day, between the endless offer of articles and the technicalities, we have more doubts and contradictions.
Eventually, it becomes inevitable to recognize that the amount of information, links and videos can overwhelm us and that we are not able to juggle so many tabs: we have become infoxicated. This invites us to carry out cursory searches, without much contrast. In the old library style we think: “if I find something here, I’ll be happy.” This search strategy is comforting, and of course inadequate. “Don’t believe what you first read” has never been more appropriate. “Maybe it would have been better not to read anything on the Internet,” I have heard people say. No man, don’t get discouraged: reading is always good. What is certain is that looking for answers there requires realizing that the digital ecosystem requires new tactics.
The Internet does not understand its own content, and therefore is unable to give it to us in the format we need. When you want to buy a bicycle, the Internet will tell you all the details you may need about that and all bicycles. You will be able to meet the manufacturers, watch a video about the history of cycling in Spain and buy shares on the stock exchange of the producers listed there. However, it is usually a shop assistant who, through two well-directed questions, will recommend a bicycle appropriate for your level of proficiency. Asking the Internet “what is the right bike for me?” It’s like asking Dr Google “what should I do about my bunions?”
So, what does the Internet have to tell us about our health? Without a doubt, there is more information available than one can read. But can Dr. Google explain to me the reason for my symptoms? Can He treat and predict Me? No. In this article we will be constructive: How can senior citizens relate to the Internet in a beneficial way?
The first thing you need to know is how to search. Searching for information involves filtering the sources, recognizing whether the query page is an academic search engine, a blog written by a healthcare provider or a company. Sometimes, we find health sources where services are offered and other times a user forum with shared experiences. Each resource has its role.
On the Internet you find what you want to find, although many times without wanting to (or without realizing it). Consider that health professionals regularly attend specific training workshops in online literature search. In these workshops we learn to use keywords, metadata and logical connectors to improve the chances of finding what we are looking for (and being able to trust it). In other words, on the Internet, those who search do not necessarily find and it is not trivial to train for it. Despite having taken the workshop, many times one does not find a concrete answer, but is rather able to explore information environments where the answer can live.
It may also be interesting to explain that much of the information we consult (and that we consider reliable) is found in search engines that require some type of subscription or payment for reading rights. These writings of high academic value are not always helpful for your specific case. They focus on the study of samples and not individuals. Furthermore, they are still subject to publication bias: scientific editors are much more interested in publishing information about the complications of a procedure. We have little left to learn from the cases that progressed well, with patients satisfied and back to their normal lives. For this reason, academic literature tends to be dry and threatening to the reader.
Other articles available in more experiential format, such as writings from people and patients, blogs and reports, should be read knowing the biases surrounding such publications. An example is the so-called survivor bias. This is the overrepresentation of experiences of a certain type, such as adverse events or complications. On the Internet, it is more likely to come across a complaint than a compliment. This is why (among other reasons) hospitals tend to have poor search engine ratings (at least compared to restaurants).
A new application of the Internet is the creation of communities for specific problems. A long time ago I collaborated with a website that brought together survivors of severe head trauma. In it, video interviews were conducted with the patients and their families and they explained particular aspects of their daily life. In addition to making the disease visible and destigmatizing it in the eyes of the general population, the page was full of interesting and useful content for these families: contact numbers, exercise guides or specialized providers. It had a private blog that allowed these people to interact with each other and they even organized an annual meeting, with money collection and donation to the hospital.
Not all communities are constructive for everyone. An acquaintance of mine suffered from chronic pain for years and gave up her search for answers online because doing so caused tremendous emotional stress: “I only read people’s complaints.” The usefulness is determined by the user, but without a doubt the Internet is a portal to people with life experiences similar to their own. Furthermore, one of the few ways to humanize the Internet is by finding other humans to share the path with.
Thus, nothing is more futile than typing in the symptom that afflicts you and waiting for a diagnosis for your condition. Despite this, curiosity and the desire for answers mean that every day tens of thousands of people consult Dr. Google about his symptoms, promoting self-diagnosis. The search for answers is not bad per se, but self-diagnosis poses two risks. One is that it can delay receiving appropriate treatment (if you need it, of course). The other is that it increases the anxiety that we often feel when trying to maintain good health.
The search can be a casual act, without major psychic significance, or a spiral towards the so-called cyberchondria, or hypochondria of the cybernaut. For some people, searching for symptoms on the Internet is already a modus vivendi and not only compromises the hours spent in front of the screen, but also the hypervigilance in which one lives, seeking to record even the smallest of symptoms. On the Internet you find what you want to find and certain definitions can easily lead to self-fulfilling prophecies.
Anyone who reads the diagnostic criteria for certain personality disorders, or the non-specific symptoms of the onset of some oncological diseases, may end up convinced that they suffer from both. For these diagnoses, a greater context is needed than just the list of criteria. Usually, this context results from the interaction between the doctor and the patient.
Here’s another thing Dr. Google lacks: empathy. Empathy and the orderly and progressive delivery of information can determine a person’s reaction to certain news. Not all people who visit the doctor should be approached or informed in the same way. How we receive information is as or more important than the information we receive. For example, if I offer someone a treatment in pills having established a previous relationship and I warn of possible side effects, the possibility that the patient will discontinue the treatment if these side effects appear is much lower than if the patient and I do not know each other at all. , if I didn’t give the warning or if the suggestion was given by a neighbor or a blog. This is something that the Internet does not contemplate. And neither do we, when visiting Dr. Google.
Of course: the search for information, carried out with caution, can greatly lubricate your meeting with the doctor. Arriving at the consultation informed can help you make better use of your interview time. There are people who come to the consultation with a lot of information already read, they carry printed images and informative diptychs. They bring with them a list of questions. They come to clarify some term, to confirm what they already suspect and to receive a more in-depth opinion. It is in these meetings where the true power of the information available on the Internet is evident. For this group of patients, medical paternalism’s days are numbered: some no longer go to the doctor to be told what they should do.
Returning to the bicycle example: since time is limited, if you limit your uncertainty to the three bicycles in the store that are closest to what you think you need, you will receive a much more profound and accurate comment than if you hesitate among all of them. those available from the catalogue. Here’s the crux of the matter: use the Internet to learn more about lumbar spinal stenosis; But don’t expect answers about your stenosis.
When consulting health topics on the Internet, we should all follow certain basic rules to ensure primum non nocere. In 2018, the Official College of Physicians of Barcelona published the Decalogue of Recommendations for the use of Health websites. If Dr. Google had a waiting room, this document would be on the table for you to read. Start there.
