The risks of self-diagnosis and the role of medicine tomorrow

One patient in three practices self-diagnosis using information found on the web.
This is the figure reported by the scientific news site "Doctor News 33", thanks to Dr. Ovidio Brignoli, vice president of the Italian Society of General Medicine (Simg), regarding Health Online 2013, the American survey that highlighted the scale of the phenomenon of self-diagnosis carried out via the Internet.
As part of the Pew's Internet and American Life Project, more than 3,000 people were contacted by telephone, and it emerged that in the US one person in three self-diagnoses on the Web, and a third of these do not even ask their doctor for confirmation.

The issue is not new to the headlines: as early as 2011, several studies confirmed the phenomenon as a growing trend in the social behavior of Italian patients. A recent quantitative study conducted by the London School of Economics estimates at 24 million the number of Italians who turn to the web to search for medical information, and the data appear to be confirmed by the noteworthy analysis conducted by Eurisko in 2011, "Pazienti e web".

Dr. Brignoli rightly points out that the problem is not so much the availability of information as it is information that is «unfiltered, unregulated and often not authoritative, so it can happen that what you read is not correct[...]».

Now, in our view, the problem needs to be analyzed in detail to better understand what the best response might be, since social phenomena that arise and evolve on the web have peculiar characteristics, and it has been amply demonstrated that they tend to escape rigid forms of control or restrictive measures.

The Pew Internet Health Online 2013report highlights a particularly interesting figure: while internet use appears to be entrenched in over 80% of the US population, and of these internet users a full 72% say they have searched for medical information on the web, as many as 77% of searches started from a search engine (Google and Yahoo, to name just a few), while only 13% of searches went directly to specialist sites.
In addition, a quarter of internet-using patients said they had come across paywalled information, and only 2% agreed to proceed, while over 80% of patients launched a new web search to obtain the same information for free.

In this landscape it is not difficult to come across self-interested information, offered directly by industry operators, which lacks the impartiality that should distinguish medical-scientific opinion. Or "peer" information, based on the exchange of mutual experiences, a sort of "social Medicine" founded on peer-to-peer rules.

The trend identified by the American study and confirmed by the Eurisko data for Italy highlights a further tendency of the internet-using patient, which is to attempt, through information retrieved on the web, a self-diagnosis, believing they have identified the cause of their symptoms — which all too often translates into "do-it-yourself treatments" that are dangerous to the individual's health.

The data from the health online study also show that this phenomenon tends to be concentrated among higher-income, more highly educated social groups, and not among segments of the population with lower education and income.

The role of the doctor therefore does not appear replaceable, especially in the anamnesis phase, the moment when the doctor gathers from the patient's own voice the information, the description of symptoms and the sensations that help the professional formulate a diagnosis.

According to Nutricity, tomorrow's challenge will therefore not be an attempt — which promises to be unsuccessful — to regulate the medical information market, but rather to bring doctors and medicine closer to the world of the web.
For many patients, medical science appears close to a technical trade, and just as one asks a technician for an estimate before choosing, so the patient turns to the doctor eager to compare different views and opinions, convinced of finding a perfect solution or one better than the others.
Our "nutricity" information model tries to intercept these social trends by recreating a small, thinking and open scientific community, where the patient can find the result of the interaction of various professionals and professional figures linked to the world of Nutrition, thus overcoming the impasse between retrieving information and interpreting it, something the individual patient cannot always accomplish.