Patient, heal thyself

As a GP working in a digitally connected era, I find there’s one thing above all that patients tend to apologise for doing. They worry that I disapprove of them looking up their symptoms on the internet. Yet this couldn’t be further from the truth.

GPs spend a lot of time thinking about how best to structure consultations. The key to a successful consultation is not just identifying physical symptoms, but also determining a patient’s state of mind—and crucially, trying to discover his or her secret worries.

These are the anxious, intrusive thoughts that send people downstairs to their computers in the small hours. Here technology is a gift for the physician. Information found online can serve as a passport for expressing these concerns. It allows patients to confess fear and vulnerability without being forced to admit sole ownership of these thoughts; it allows a doctor to address these concerns explicitly and without judgement; and it can often help to lay them to rest effectively.

I also believe that doctors could benefit greatly from using online resources in a more upfront way with their patients. Most modern patients are not naive enough to imagine that their doctors retain all the knowledge they need in their heads and doctors should not be arrogant enough to pretend that they can. As I have found in my own surgery, being able to show patients online photos of their rash, lump or bump is invaluable in increasing their confidence in your diagnosis, just as being able to check the latest guidelines on how to manage an infrequently seen condition ensures best treatment. A YouTube video about earwax is one of the most useful resources I’ve ever come across. And directing patients towards well-run digital resources can help them learn, access other services, and realise that they are not alone in their illness.

It isn’t all good news, of course. With more and more people having the internet at the tip of their fingers at all times, it’s easy to get into the habit of Googling every minor ache. Occasionally, this can lead people to spot a serious illness early. But the general trend is the medicalisation of every aspect of our health: a potentially stressful and wasteful business for all involved.

While the NHS has already moved some way from being simply a health service dealing with illness to a wellness service dealing with quality of life, too great a shift here is simply not sustainable. It does not, moreover, help us to reach the population who most need help: those who are prevented from accessing doctors due to personal, cultural, social or physical barriers, even in cases of very serious ill health.

It is these people above all that technology can help. But, as with most digital tools, this is only likely to happen through a policy of openness on both sides of the desk.