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Asking Doctor Google

The internet is an awesome resource - it offers us a world of information at our fingertips.  I love that I can look up supplements my patients are taking and we can review the ingredient list online together.  I love that I can do a quick literature search on any topic when my patients share a recent diagnosis I don’t know much about.  But it can also be a platform for anyone with a snake oil to try to wrangle a dollar out of an unsuspecting subject.  Many of my patients do their own research and I don’t discourage this; I truly believe that being informed is powerful.  However, I also know that some of the information out there is at best misleading and at worst completely false.
 I recently had a patient come in to see me to discuss a diet and supplement protocol she and her partner had found while searching for options to address a recent diagnosis.  Before investing in the supplements, they wanted to know what I thought about the program.  Because this was not a site, program, or supplement with which I had any familiarity – I began researching the site for them with what I call open-minded skepticism.  I would like to share with you how I evaluate a website for my patients.

There are two basic questions I ask as I approach the site (1) what are the qualifications of the author and (2) not what, but HOW are they trying to sell. 

Question #1: Qualifications
To address the first question I review the “about us” page – here I like to see a bio with the credentials of the individual or individuals who claim they are going to save you.  Now, I will admit – I am biased toward seeing an MD somewhere among the credentials, but I try to curb this bias when I evaluate sites. There are some individuals with no formal medical training for whom sick children or family members have driven an aggressive reading of the medical literature.  These individuals approach the literature without the biases that we are taught in medical school but with the bias of including only the literature relevant to their personal situation.  Some of them have done amazing work and have very strong arguments for their approach.  However, in the absence of having treated many patients, some individuals become extremely dogmatic about what worked for them or their family, and don’t have the scope to recognize the subtle differences between individuals that may cause you to need a slightly different approach.   An example is someone who stopped eating corn and had their Interstitial Cystitis (IC) symptoms resolve.  In my mind, this suggests that IC can be triggered by certain foods and therefore a careful and comprehensive look at dietary triggers and GI function should be undertaken, while the patient whose symptoms just went away may be preaching a corn-free diet for everyone with IC. 
I also follow-up on any use of the word “doctor.”  I am a medical doctor, but my high school English teacher had a doctorate in education – we referred to her as ‘Doctor’ in class.  There are many sites out there written by “doctors” – they can be MDs, NDs, Chiropractors, or PhDs.  Anyone who refers to themselves as “doctor” should be willing to share their educational history with you.  Again, there are PhDs out there who may know an awful lot about a condition, but they are not licensed to treat people (except for PhD level nurse practitioners) and may lack the clinical experience you will find from a medical practitioner.  You deserve to know the level and type of training your expert has – all of us in the healing professions have come to our knowledge through different paradigms and this alters our approach to healing. 
Question #2: The Sales Pitch
This is where my radar really goes up – what is this expert trying to sell?   I have no problem with someone who has worked hard to develop a program or a product earning a living from the fruits of their efforts, but I do get a bit suspicious when there are reports of clinical outcomes or a suggestion that an item has been tested, with no reference back to the medical literature.  A few years ago I had three patients who were involved in selling a product through a multi-level marketing program.  They were adamant about the advantages of the product and, honestly, they all looked and felt great while on it.  As I reviewed the site, however, I noted that everything was “proprietary,” including the technique that had been used to “prove” the product worked at the cellular level.  There was absolutely no way for me to review the studies, or even to find out if the testing methods were valid.  While the lack of transparency doesn’t mean there was anything to hide, I simply had no way to assess the product.  This was not something I could, in good conscience, recommend to other patients. 
I am dogged with my research here – I have seen sites which list reference links that just move you to another page on the same site and links to references which go nowhere.  Some pages will list medical articles to support their claims, but when I pull up the articles and read through them, they actually refute the argument that is being made. 
Finally, I try to assess the tone with which the sale is happening.  If the site uses fear tactics to try to convince you that all other similar products are going to kill you, or to convince you that your regular doctor is stupid, it’s a site I’ll be done with immediately.  I’ve been doing this long enough to realize that anyone who approaches healing for any length of time develops a good dose of humility.
So, if I query Dr. Google and I find information from a well-informed individual who is willing to share his or her qualifications and why he or she cares about sharing this information with you, and this individual has a product to sell in a transparent and educational fashion, it’s information I will seriously consider.  If, on the other hand, I get a hard sell from an individual who isn’t sharing their background and won’t let me do some independent research to corroborate their findings, I’ll quickly be in the market for a second opinion. 
In Health,
Robyn W. Jacobs, MD

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