Is WebMD helping or hurting?

Healthcare costs are through the roof and are generally one of the bigger issues facing the country (when the economy isn’t overshadowing everything else). Healthcare costs also are dragging on the economy. So bringing those costs down is a very important goal. I touch on this a little bit last week, and this week is going to look at another small piece of the puzzle–you.

Getting costs under control is going to require everyone, from doctors and pharmaceuticals to the patients themselves. For example, the CDC reports that in 2008 there were 123.8 million ER visits. According to the Director of the federal Office of Management and Budget, almost $700 billion is wasted on unnecessary care. Some of this unnecessary care comes in the form of unneeded ER visits. This article contains links to sources for both claims. It also makes some good counter-arguments in terms of saving costs on ER visits. But I’m not trying to argue about how much we could save on ER visits.

In general, patients can help cut healthcare costs with some education. We should be teaching high school students when they need to go to the doctor and when they don’t, about health insurance, and the differences between name-brand and generic pharmaceuticals. (Also, the importance of healthy eating. I’m pretty sure that was covered in my 9th grade health class, but I didn’t get much out of it. And everything gets overcomplicated when it comes to healthy eating). It would be expected with increased internet access that patients would have better access to health information. I’m sure sites like WebMD and Mayo Clinic Health Information pop to mind.

So why haven’t we seen a decrease in costs (or unnecessary ER visits) as more people have gotten access to the internet and its wealth of health information? It’s a good question, and I don’t have the answer. But I do wonder if sites like WebMD are actually helping or hurting things.

1. Easy Access Info

First, the positive side of things. Like I said, the wealth of information should be great. Not feeling well? We can check online now to try to figure out what’s wrong. We can get advice ahead of time on whether or not we need to see a doctor. We can be more informed and have useful questions for the doctor when we do have to go there. Everything about the sites seems like they should streamline things, making everything more efficient.

2. The Problem with Sponsorships

WebMD is far and away the most popular site. When I mention going online to look up health info, I’m pretty sure WebMD is what popped into most people’s heads. However, very few of you probably realize that WebMD is a sponsored site, driven in large part by pharmaceutical companies. This New York Times article does a great job of breaking down the problem. One quick example from the article: results on WebMD often skew towards the more extreme instead of showing the most likely problem and showing it in a calm and informed manner.

And here’s another sponsorship problem. In this case, Kellogg advertised on WebMD’s site trying to dispel “myths” about sugar. It’s an ad promoting sugar intake for children–on a health site! There’s a serious problem with that.

Now, there are other options out there. Mayo’s site is similar to WebMD, while being not-for-profit and a generally less biased source. (In an effort to remain balanced, here’s an article in response to the New York Times article above, defending WebMD. I find most of the arguments fairly weak, but it’s there for those of you who are interested).

3. They’ve Made Everyone a Hypochondriac 

When you plug in your symptoms on WebMD’s symptom checker, which results do you tend to skew towards? Most people, and myself included, tend to lean towards the more serious or extreme issues.

Here’s a personal example. My right wrist has been bugging me from time to time. I’ll have a decent amount of pain on top of my wrist and opening and closing my hand doesn’t feel great. Occassionally, I’ll even have slight to moderate numbness in my ring and pinky finger. After checking stuff online, it’s pretty clear that I have Carpal Tunnel Syndrome, right? ….Or here’s an idea. Maybe a couple of the tendons are just a little bit inflamed. Perfectly reasonable after a weekend of tending bar when my wrist can get twisted in a lot of uncomfortable or strain-inducing positions. So instead of looking at a probable surgery down the line, I probably just need a few days and maybe an ibuprofen or two.

And that’s a fairly minor example. People are too alarmist and assume the worst. Instead of using the sites to make informed decisions, people are jumping to wild conclusions. And worse…

4. They’re Hurting Our Trust In Doctors

Don’t get me wrong. Doctors screw up from time to time. And having more information for the patient is a good thing. They might catch something the doctor overlooked. And there are doctors out there that probably don’t deserve their patients’ trust. But this ties directly in with my last point.

People are making wild assumptions, and then when a doctor says that it’s probably just a virus–it’s not what they want to hear. It’s the way people are. If I’m convinced I have something much worse than a virus, then I’m going to assume that the doctor is marginalizing my problems. Clearly the doctor can’t understand exactly what I’m going through. Therefore, the doctor doesn’t understand the severity of my condition. Every single sniffle becomes a cause of concern and more evidence for my claim. And then a week later, it’s gone. Because it was probably a virus.

These sites should be helping make patients’ healthcare experiences more efficient while increasing a patient’s ability to play a role in the process. Doctors and patients are partners–not provider and recipient–and a more informed patient is a good thing. For many people, these sites have helped push things in that direction. But for too many others, it’s going the wrong way. People need to be more cognizant of the risks of overreaction when using these sites, while being aware of potential biases (remember, Mayo instead of WebMD). A smarter patient is a healthier patient, and that’s everyone’s goal. And one key step towards getting costs under control.

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