The NHS needs to take cyberchondria seriously
Doctor Google, paging Doctor Google! Doctor Google, please report to reception, where 16million patients are waiting…
The latest dispatch from the clinical front-line is that public-health anxiety has risen to the point where “cyberchondria” is now a thing. A really big, possibly malignant thing that has one-in-five outpatients swiping across and scrolling down in the silent watches of the night.
They turn up at A&E units in a genuine state of wretchedness after self-diagnosing and invariably reaching the most calamitous of conclusions. It sounds silly, and it usually is, but it can also be a very real and frightening source of distress, as well as a waste of time and resources.
Let he who has never casually searched “random chest pain” or “aching joints” cast the first aspersion. I once turned up to see my GP exhausted and insomniac due to an unshakeable conviction that I was going bald after I discovered an enormous bare patch on my head.
A tiny area of skin had been stretched taut due to a mosquito bite; the emotionally intelligent GP, quite rightly, saw through the alopecia red-herring and instead diagnosed me with clinical depression.
It’s easy to mock the epidemic of cyberchondria, but we’ve all looked up our ailments online because that’s where we live an awful lot of our lives now. We use the internet for shopping, dating, reading and education. It’s the first port of call when a best man wants to write a speech, or a lover wants to pass off just the right poem as their own. So it stands to reason we would consult medical websites just to, you know, check out that strange tingling sensation. It’s probably nothing. It’s almost definitely nothing. Either that or it’s a heart attack. Or cancer. Oh God, I’ v ego tAb de rh alden kaufman n-lign ac syndrome! Yes, it usually manifests itself in infancy – but “usually” doesn’t mean “always”, does it? Give it to me straight, doc!
There will always be serial attentionseekers whose idea of a good night out is spending four hours in the uncomfortable bucket seats of a casualty unit waiting area. Tune into the BBC documentary Ambulance, and your abiding admiration will be less for the paramedics’ astonishing life-saving skills, and more for their superhuman ability not to lose their tempers with the recidivist timewasters and the chronically stupid who call 999 when their remotecontrol batteries need changing, or they’ve run out of nappies for the baby.
Why? Because there’s a recognition that mental health issues – dementia, personality disorder, bipolar disorder – all feed into health anxiety. Which is possibly why researchers, including those from Imperial College and Kings College London, who have identified “cyberchondria”, aren’t suggesting these people be blacklisted, but rather that psychotherapy be employed to help them. But that would involve the sort of joined-up thinking that is sadly not the NHS’S forte, where any sort of major change is implemented a heck of a lot slower than on Holby City.
Change, however, is needed. Now that half of all GPS want to close their patient lists, the overflow will inevitably find its way into hospitals, where cyberchondriacs are already costing £420million a year.
Of course, given all that, it’s easy to be dismissive of the many. But every so often, a harrowing story emerges of the few: the parent turned away by doctors who goes online and identifies the cause of their child’s suffering, the desperately ill patient who pleads for help and is treated as a fantasist.
In 2014, Georgina Horton-jones, from Haverfordwest in Wales, was concerned that her newborn baby, Isabella, was too small and failing to grow. Doctors reassured her that all was well and that she would catch up.
After extensive research online, followed by a raft of private tests, a geneticist confirmed Isabella had a rare form of dwarfism. This is now being monitored by the NHS.
A year later in Essex, doctors diagnosed nine-year-old Brooke Smee with “abdominal migraine” after she threw up every day for a month.
Her mother turned to the internet, where an NHS Direct page on brain tumours convinced her to beg for an MRI scan. Brooke was diagnosed with advanced medulloblastoma, a tumour that Great Ormond Street Hospital experts said would have killed her within days had she not been treated.
There are many other examples, but one of the most poignant is that of Bronte Doyne, 19, from Nottingham, who begged doctors to take her seriously in the months before her death from liver cancer and was told: “Stop Googling your symptoms.”
Her anguished social media entries, always accompanied by the hashtag #helpme, serve as a heartbreaking epitaph. Meanwhile, the Nottingham University Hospitals NHS Trust has admitted it “did not listen with sufficient attention” and that it must embrace the “internet age”.
The truth is that Doctor Google is a catastrophist who gets the diagnosis wrong far more often than he gets it right. Which is why we do need highly trained professionals whose job it is to listen in the internet age, who are skilled enough to recognise the difference between aches and pains fuelled by anxiety – make no mistake, mental illness affects the body and can give rise to physical pain – and the presence of a legitimate concern.
I know the resources are stretched – and by the way, hang your head in shame, Mrs May, for denigrating a pay rise for nurses as frittering money “on this and that” – and cyberchondria is an affliction of the mind.
But with the current fresh focus on mental health, here’s the perfect opportunity for synergy.
Everyone who turns up at A&E is seen by a triage nurse who decides the best course of action. Why not also provide a parallel psychological triage service for anxiety issues?
It would save resources in the long run, because a healthy body without a healthy mind isn’t healthy at all. Doctor Google knows that, and he isn’t even a doctor.