Wednesday, July 29, 2009

The Internet and Emergency Care...

I suspect that the use of the Internet has saved many lives. With extensive search engines like Google and Wikipedia, people have easy access to information (not necessarily accurate information). There is a tremendous amount of medical information sites, some with great information and others with not so great info. Nevertheless, people use the Internet every minute of the day.

It is not uncommon for me to see a patient in the ED who comes in and says, "You know, I just didn't feel right, I developed some chest discomfort or indigestion, and I went on the Internet and the site suggested that I seek out medical attention." Well in general, that's a good thing since, for example, many woman do not have typical symptoms of a heart attack such as "crushing chest pain" but rather fatigue which they downplay and do not often seek timely medical attention. Clearly, when someone is having a heart attack or MI (myocardial infarction), "time is tissue" meaning the shorter the duration of seeking medical care the better chance of saving heart muscle. And, that is no different for strokes or "small" strokes (TIA's). With strokes, many people are not educated on the symptoms and often neglect them until it's too late.

On the other hand, the Internet has also driven up the cost of health care for ED visits. Frequently, I'm scratching my head at 4 a.m. when a patient presents with a variety of symptoms, and I'm trying to figure out exactly what is going on. Why did the person decide to come to the emergency department at 4:00 a.m. with a constellation of symptoms that don't make sense other than generalized anxiety. I often ask the question, "I'm curious, the way you're feeling started at 10 p.m. last night, what changed for you to come in at 4:00 in the morning?"

Often I hear, "I couldn't sleep, so I went on line and plugged my symptoms in and I thought I had cancer!" Something that wouldn't change at 4:00 a.m. but adds to the patient's anxiety.

Where in the world could you get a reasonable answer to your medical concerns 24/7. Try calling your physician at 4:00 a.m. to tell him or her of your symptoms and let them know you think you have cancer...see what the response is...sometimes it's "go to the ED" (so they could go back to bed)!

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