Sometimes Doctor Google is Right

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The White Coat Investor

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I had a patient come in this morning and tell me she was worried she had diabetes.

27 years old, 2 weeks of polyuria, polydipsia, and two separate glucometer readings of over 300. Then over the last 24 hours, she started vomiting and feeling ill.

She had already read up on DKA and diabetes and wanted me to tell her that she didn't have it. Of course, she did, so that didn't work out so well.

What have you seen patients successfully diagnose themselves with using the ever present Dr. Google?

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I had a patient come in this morning and tell me she was worried she had diabetes.

27 years old, 2 weeks of polyuria, polydipsia, and two separate glucometer readings of over 300. Then over the last 24 hours, she started vomiting and feeling ill.

She had already read up on DKA and diabetes and wanted me to tell her that she didn't have it. Of course, she did, so that didn't work out so well.

What have you seen patients successfully diagnose themselves with using the ever present Dr. Google?

A patient told me that she was worried that she had hypothyroidism based on her Google search - she was puffy, tired, emotional, and always anxious.

TSH was > 125.
 
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A patient told me that she was worried that she had hypothyroidism based on her Google search - she was puffy, tired, emotional, and always anxious.

TSH was > 125.

Bells Palsy seems to be a common one for me. Which is nice, because it makes it much easier to reassure them that it's not a stroke. I wish there was a comparable diagnosis for fingertip parenthesis...
 
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I had people self diagnose PE, appy, and Bell's correctly before. The non hypochondriacs tend to do decently when it's a classic presentation
 
More commonly, I have patients demand to be "tested" for [insert bizarre, likely Eponymous diagnosis here], and of course - we can't do that.
 
Had a 16yo with a crush injury to his finger and resultant subungual hematoma. Looked up how to treat it, drilled himself a perfect hole using a Dremel tool, drained all the blood, and just came in to us for an x-Ray. I told him to seriously consider a career in medicine after finishing high school...
 
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Had a 16yo with a crush injury to his finger and resultant subungual hematoma. Looked up how to treat it, drilled himself a perfect hole using a Dremel tool, drained all the blood, and just came in to us for an x-Ray. I told him to seriously consider a career in medicine after finishing high school...

I did the same thing when I was in undergrad. Only I heated up a needle with a lighter and burned a small hole through my nail to drain it. Getting all that blood out never felt so good.
 
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From my personal experience, broken limbs are pretty easy to diagnose even without medical training.
 
More commonly, I have patients demand to be "tested" for [insert bizarre, likely Eponymous diagnosis here], and of course - we can't do that.

Every dog finds the bone once in awhile. For every 100 that comes in with a diagnosis, I may get a few that is even close to being right. I tell pts to stay off Google
 
My favorite was the guy who came in saying, "Doc I need as Esmolol drip!"

He was right.
Doc, doc... I need that drug that starts with E...
 
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I had a druggie carrying another druggie slumped over his shoulder into the ER... "Get the Narcan!!!" We got the Narcan. Saved his life.

We obviously would have gotten to the Narcan without this guy's help, but it did save some time.
 
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I was in the ER admitting a patient, when I heard the nurse checking in a patient with the chief complaint "I think I have a ruptured ectopic with internal bleeding"

Turns out later in the day, I end up admitting a ruptured ectopic s/p surgery s/p multiple transfusions.
 
I have patients routinely coming in self diagnosing their own dilaudipenia.

But sure, simple stuff like -- I think I have diabetes. That's not too impressive, because... you probably do. Just like everyone else in the ED.
The annoying part of Dr Google is when patients come in with demands for MRIs checking for zebras. Makes for unpleasant working conditions.
 
I have patients routinely coming in self diagnosing their own dilaudipenia.

But sure, simple stuff like -- I think I have diabetes. That's not too impressive, because... you probably do. Just like everyone else in the ED.
The annoying part of Dr Google is when patients come in with demands for MRIs checking for zebras. Makes for unpleasant working conditions.

That's when you just explain that they won't let you order an MRI for a non-emergent reason in the ED. Let "they" take the blame on that one, then move on to what you're actually going to do.
 
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That's when you just explain that they won't let you order an MRI for a non-emergent reason in the ED. Let "they" take the blame on that one, then move on to what you're actually going to do.
exactly what i do.

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That's when you just explain that they won't let you order an MRI for a non-emergent reason in the ED. Let "they" take the blame on that one, then move on to what you're actually going to do.

That's a good strategy. One I implement often. But only works in certain patient populations. Unfortunately, I currently work with an entitled patient population which takes more explaining, and unfortunately sometimes more bargaining. (and people don't like to hear their conditions are non-emergent)

And of course the MRI is just an example. Dr Google extends much further than simple MRIs. Furthermore, the point is that the extra effort and energy expended on Dr Googlers is taxing.
 
I tell them that if they need an mri, that requires me to admit them to the hospital.

If they agree, I order the tests, admit and move on.

This is of course after trying to get them to go home.
 
Had a colleague diagnose a guy with Tetanus...I asked him how he knew?
He told me he came in (with clenched mouth) saying "I tink I have tetanus." To bad he didn't google what to do after stepping on a rusty nail.
 
Had a colleague diagnose a guy with Tetanus...I asked him how he knew?
He told me he came in (with clenched mouth) saying "I tink I have tetanus." To bad he didn't google what to do after stepping on a rusty nail.

Huh. For all the tetanus updates I've done, I've yet to see or know someone who has seen it. Yay, vaccinations.
 
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