Doctors, not Dr Google, are the answer


By Dr Preeya Alexander AKA The Wholesome Doctor*
Monday, 10 September, 2018


Doctors, not Dr Google, are the answer

The patient looks at me, desperate — “But what do you think it is Preeya?” Honestly, I have no idea — which is not what I say out loud to the patient who is getting increasingly anxious about the abdominal pain she has had for 3 days. “I know it’s nothing nasty — your appetite is normal, you don’t have a fever, your tummy is soft on examination and you’re still able to attend work and the gym despite the pain — so I think we should catch up in 72 hours and see how you’re going. If anything changes you come sooner.” She stares back at me — “OK, but what’s causing the pain?”

The truth is that we don’t always have the answer. Despite how the community often perceives us (or how we project ourselves), doctors are not magicians. When I tell my patients “Honestly, I don’t know” or “I can’t answer that” I’m often faced with a shocked expression — “But you’re meant to know everything” a patient once said to me.

Single diagnosis? Not always

Medicine is grey, very very grey (certainly more than 50 shades) a lot of the time. Perhaps not all of my colleagues will openly share this — but we don’t always have a single diagnosis for a patient’s tummy ache/headache/fatigue, we don’t always know what’s going on in the human body.

As a GP in particular, we often rationalise symptoms; we know common things occur commonly, we know there are certain life-threatening diagnoses like meningitis or an ectopic pregnancy that we cannot miss — but we can’t always tell a patient with 100% certainty what is causing their niggling symptom.

Time or what we call “watching and waiting” in GP land (as it is known) fixes these non-specific symptoms they have; we may never know exactly what caused their ache or niggle but it settles on its own simply with time.

Recently a friend of mine, also a GP, suggested I explain that when we say “I’ll just look up the guidelines” or “I’m going to check the dose of that” we are not “googling”. I’ve heard from multiple patients and family members that a doctor started “googling” in front of them; they’re completely shocked as if the roof on the doctor’s office had blown off and Dorothy (with Toto) had flown straight over with her ruby red slippers mid-consult.

Guidelines, not Google

On behalf of my profession, let me be honest — we cannot possibly remember every dose of every drug, every management regime, every set of blood tests that should be ordered when we suspect someone has lupus. We often look at guidelines — not Google — from reputable medical bodies that exist to help doctors navigate the abyss of ever-changing medical information.

Sure, there’s probably the odd doctor who really does “google” but I can tell you most of us don’t. When I say “I’m going to see what antibiotic we should use here given you’re allergic to penicillin” or “We need to exclude you don’t have an underlying cause to your high blood pressure — let me check which tests we need to do for someone in your age group” I’m not asking Larry and Sergey (they founded Google — I had to google that to find that out), I’m consulting my medical search engines.

And on that note, while we are discussing Google, please know that I have done years (and years!) of study and practical training to sit in my office with my plaque outside my door. So, when a patient says to me “But Google suggested I have a brain tumour” please know that my years of study and the heart beating in my chest make me a sounder medical practitioner than their laptop. I may not have all the answers, I will admit to that, but I promise I can do a better job than Google at diagnosing a headache.

*Dr Preeya Alexander is a practising GP working in Melbourne and a graduate of Adelaide University. She is passionate about all things ‘prevention’ in medicine. A wife, mother and doctor, Preeya shares her tips on staying healthy with medical-based evidence on her blog The Wholesome Doctor, at www.thewholesomedoctor.com.au.

Image credit: ©stock.adobe.com/au/F8Studio

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