Tech IT Easy

Medical Wysiwig?

By raphael encaoua, May 14, 2007

To all Tech IT Easy readers, who could obviously not necessarily remember the initial announcement, I have invited my friend Raphaël to blog about how he is using web technologies as a business enabler in his new medical tourism venture (blog). Raphaël’s mission statement is to dig into IT applications in the medical field as well as e health matters. . Raphaël, they’re all yoursŠ²

Wow! Finally this is my first post! When talking about my contribution on this blog to Jeremy, the latter was a bit skeptical: who cares about kidney transplant! I am an IT man you see. IT! Though I was afraid I didn’t back down and pointed out the fact that the medical field was full of IT stuff as interesting as an I Pod or Windows Vista for one’s everyday life. Plus, my mother always wanted me to be a doctor so I must do something to fill the gap. Jeremy I promise you to be as simple as I can. If not, you can sing Take it eaaaaaaazy by Micka forever.

While working on my medical tourism venture project, I came at grips with the problem of medical follow up and the ability of anyone to understand its medical condition. In fact, what annoys me is the difficulty that one has when managing his health status. If one can understand with some training some parameters (like simple indicators such as cholesterol, blood pressure), the ripple effects of any change of his condition is way more difficult to judge. A patient lacks a global view on his medical status. Let’s take my own example: am I facing some stress now but am I suffering from anxiety/panic disorders nonetheless?

The main psychological barriers leading to self health are:

+ our lack of knowledge

+ our own medical methodology (you’ll understand later)

+ the trust we place in our doctor to do everything

+ the lazyness we express when trying to understand what’s going on

Online materials are really helpful to tackle this issue through the use of innovative research tools: medical maps. The website healthline.com helps anyone first guessing he is suffering from a particular disorder to beter understand his health status and screen himself what is going on. So in my case I must study the panic disorder mapping. I see the roots of my anxiety disorders (stress, poor diet, drug and illness) and try to figure out what the symptoms really are. I am not an apprentice doctor so I must genuinely understand what’s going on before pretending having anything by finding reputable information. The research tool brings me to emotional.health.ivillage.com, where are discussed mental disorders. Yet I just have major stomach pain. I further browse and I get on PanicPortal.com, where are discussed behavioral problems. Still I don’t fit into that box. My method was totally non sense. I tried to first guess my disease before seeing if my symptoms matched. Yet, this kinnd of mapping gave an excellent overview of what anxiety disorders are and I could see that they are often related by other things than mere stress. I got all rolled in one buritos symptoms, diagnosis, medication, prescription etc etc. Please note that this content is yet not mixing personal datas (which is another problem I will heavily stress upon later).

Medical Mapping (’healthmaps’) allows anyone to see what he has: What You See Is What You Have (WYSIWYH).

Education, Internet

LF

Hello Raphaël,

Interesting post! It raises the question of the utility of thi new generation of websites.

Like many colleagues, I’m very sceptic about the efficiency and the utility of such pseudo-medical web tools. We actually think that theses tools can sometimes be a problem.

1. As you mention at the beginning of the post, there are many barriers preventing an efficient self health (not necessarily the psychological ones: like the knowledge and the experience of the MD). You do not mention one very important barrier which is the ‘hypochondriac effect’. I will try to find a paper I read a couple of years ago about the psychological consequences of medical TV programs. After watching such programs, a significant proportion of people think they have some symptoms described in the program or start to feel the effect of some symptoms. Of course, we have to consider a bias. People interesting in this kind of programs are more receptive than the other part of population who will probably be less sensitive to this effect. I’m afraid that some people feel sicker or feel new symptoms after visiting this kind of website. This could have dramatic consequences for the diagnosis by the MD. Just to remind that the diagnosis begins with questions in order to understand what could be the disease that people are suffering. Thus, if people start exaggerating some of the symptoms, the diagnosis could be become difficult.

2. A (short) story that happened to me last year. A patient came to me to speak about his disease. He told me that he was diagnosed by a first MD with a very rare genetic disease. But he had a look on internet, and he was sure that the MD was wrong and did not diagnose the right disease. He was sure to have another one (according to the forum and websites he consulted). After a couple of questions, it was clear that the first MD was right. Moreover, he performed a genetic test to confirm the diagnosis. The patient had difficulties to believe it, and finished the interview with: “are you sure of the diagnosis? I was sure to have this disease”.

To finish, I would just like to discuss about one of the barrier: “the lazyness we express when trying to understand what’s going on”. I really think it is a problem of knowledge not really a problem of laziness.

raphael encaoua

Thanks for this comment. I do agree that I went astray with the word lazy. I wanted to point the fact that people even though they wanted to have a clear view on their health status can sometimes freak out when it comes to thorny details.

The hypocondriac effect is indeed an excellent point: surinformation is perhaps an anxiogen catalyst as it poses many more hurdles to our understanding. Again, I assume that people do ot get a good grasp on the medical problems that are confronted with (at least when discovering they have or just supposing it is not a well known chronic illness to which one is used to).

This browsing tool poses a problem of timing indeed. You rightfully lay the emphasis on the fact that someone could over estimate his illness by exagerrating his symptoms when first seeing his doctors just to play the wizz kid. In fact, the underlying problem is the nature of our relation with our usual doctor: is it a pure relation of trust, is there any intellectual rivalry (such as this guy has scores of diploma while I barely graduated from highschool etc etc)

Today, we still work in france under the rule of the coloc singulier, meaning that a patient cannot legally overule the diagnosis and the prescription of his doctor, but could still seek for second opinion. Doctors are making some commercial concessions (such as offering graciously certificates justifying days of medical leave). What would it be if the medical industry was totally patient (or I daresay customer) driven?