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When your patients have questions, how do you counteract the onslaught of misinformation and malpractice that exists on the Internet?
I very often find that patients have been given non-evidence-based advice, either by friends and family, a non-traditional health care provider like a naturopath, or the internet. Every day, I see on my social media feed ads for supplements for thyroid disease or “adrenal fatigue.” I know that patients must see them, too. And once they have this misinformation, it is very hard to get them to believe in evidence-based medicine. “The article said that most doctors rely on tests, but the tests can be wrong. I thought as a specialist you would treat the person and not the numbers.”
It got me wondering whether all physicians have this problem or whether this is distinctly an endocrinologist’s nightmare. So, since Google knows all, I Googled atrial fibrillation, GI bleed, emphysema, hypothyroidism, and adrenal.
When I typed in atrial fibrillation, I got an ad for the Watchman (a left atrial appendage closure device), and links to heart.org, Wikipedia, the Mayo Clinic, and WebMD. When I searched for GI bleed, I got a link to MedlinePlus, Wikipedia, the Mayo Clinic and eMedicine. When I Googled emphysema, I got an ad for a prescription inhaler, links to two health-related search engines and a link to The Cure Is Now, an advocacy and research organization.
However, when I typed in hypothyroidism, I got an ad for Synthroid, a link to reference.com (a search engine), and number 3 was a link titled “Top 6 Hypothyroidism Remedies” which brings you to a site that reviews supplements (and then links you to the site where you can purchase them), purportedly to enhance thyroid health. On one page it says, “the current medical treatment…requires extensive preliminary and regular blood tests to avoid nasty side effects…Frequent blood tests and trips to the doctor can be a chore…Wouldn’t it be preferable to help the body balance itself naturally?”
And when I typed in adrenal, the first link was to InformationVine, which lists as the top 3 links “adrenal fatigue treatment,” “best adrenal supplement,” and “symptoms of adrenal fatigue.” I couldn’t keep looking after that.
So my little 5-minute Internet search leads me to believe that endocrinologists, more than many other specialists, are under the additional strain of trying to undo the miseducation of the general public. Patients will tell you, “but there are so many articles on the internet” to which I once replied, “you know what else they say on the Internet? That there are aliens that walk among us. I don’t believe that either.” Or they will bring in the book by some '70s actress or a doctor (of nutrition) that explains how the medical profession is just lying to them because we are paid off by the pharmaceutical companies. It is exhausting.
I try very hard to give my patients the correct information. I give them websites like hormone.org or thyroid.org where they can get reputable information. Sometimes it helps, sometimes it doesn’t. When people are tired and don’t feel well, they want to hang on to a promise that a pill will make it all better. I worry that they will find some practitioner (I can’t bear to call them physicians) who will give them some cockamamy concoction. It happens. And I have had to undo the damage.
I hope that the Endocrine Society or the American Association of Clinical Endocrinologists can launch some kind of campaign against this onslaught of misinformation and malpractice. Mostly for the patients’ safety, but also for my sanity.