I realize how incredibly tempting it is to reduce medicine to a series of algorithms. Wouldn’t it be nice if we didn’t need to see a doctor to diagnose our ills? Wouldn’t it be great if our computer could tell us what’s wrong, and prescribe next steps for us? Wouldn’t it save money if we could triage peoples’ medical needs without human intervention?
FreeMD® is an electronic doctor that conducts an interview, analyzes symptoms, and provides expert advice — for free.
So I decided to try it out. I imagined that I was a hypothetical patient – a woman in her mid thirties who had had abdominal surgery in the past and was now experiencing mild to moderate abdominal pain. My imaginary patient has abdominal adhesions from the surgery, which is causing her to have bowel pain – which could become an obstruction and surgical emergency.
I answered all the questions posed by the free MD and he responded that he had determined the most likely cause of my pain: tubal pregnancy or threatened abortion.
This response was offered even after I indicated that I was not pregnant. What would the average consumer think of seeing “threatened abortion” as a potential diagnosis for their abdominal pain? Would they know that this was the medical term for miscarriage or would their mind race to abortion clinics and ominous threats?
The problem with this tool is that it cannot take into account all the subtle co-morbidities and nuanced historical information necessary to return an accurate result. In fact, no online tool can replace a healthcare provider’s evaluation of a patient. Attempting to do so is like playing Russian Roulette with your health. Maybe you’ll get lucky and happen upon the correct diagnosis and treatment, but maybe you’ll be horribly misled and suffer irreperable harm.
Of course, companies like freeMD contain disclaimers about the service not being a substitute for a physician’s oversight. But the reality is that people are using the service to make decisions about when and if to see a professional for further evaluation. As a concerned physician, I worry about patients being misled about their health. I want patients to be empowered and to learn all they can about their disease or condition – but self-diagnosis, even with the aid of an algorithm, is fraught with danger.
My bottom line: computers will replace physicians when robots replace spouses. Similar satisfaction rates will come from either replacement option. People know instinctively that a good doctor is critical in managing their health – why else would there be so many physician rating tools, including the one here at Revolution Health? Why would Castle Connolly bother to publish their yearly “America’s Top Doctors” reports? This is not about paternalism – it’s an acknowledgement of the incredible complexity of human beings. And in this case my friends, it takes one (doctor) to know one (patient).This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.