The Internet Doctor

http://www.forbes.com/sites/amitchowdhry/2014/10/15/google-is-testing-a-talk-with-a-doctor-feature-within-medical-search-results/

Google is considering offering medical care on the internet. I have to say I think it is a bad idea.

A Convenient Resource

I am a healthcare provider; a nurse for 6 years and then a Certified Nurse-Midwife for 20 years. I have seen the internet slowly creep into my practice over time. Initially, I found the internet to be very convenient. It was helpful to use the internet to look up medication doses when I didn’t have the book to reference. And our website has helped advertised our practice so that women around the state are able find us and the kind of care they desire.

Over Reliance on the Internet for Medical Information

But over time, with the advent of smart phones in particular; the internet has negatively impacted the patient/provider relationship. As a primary care provider for women of all ages, I am no longer their subject matter expert. The internet is. When a woman calls asking about her situation, she has already googled her question and poured over the internet looking for an answer. I am then called. As I ask her to describe her complaint, she is pulling me in the direction of the diagnosis given to her by the Internet Doctor with the kind of information she gives me. She is unhappy with my lack of concern when she calls reporting that she ate meat that was not cooked medium well. The fact that she currently feels well, that that the meal has been eaten and that her situation cannot be changed escapes her reasoning as she panics. The thought that her baby might be suffering from lysteriosis, a very rare consequence to eating meat infected with Lysteria, has her lying awake in a near state of hysteria. My job in the morning is to talk her off of the ledge that her Internet Doctor has pushed her onto.

Dr. Internet Is Creating Chaos

The Internet Doctor is taking no responsibility for the chaos it is creating by giving information to people who have no way of discerning what is relevant to their situation or not. Worst case scenarios are at the forefront of the information given and the practical, common sense type of advice that our grandmothers received is hidden away and incredibly hard to find. Dr. Internet is taking away my own confidence as a provider too. I was taught in my education “don’t go looking for a zebra when there is a horse right in front of you”. The reality is, (thank God) most people do not have the pregnancy-complicating disease like listeriosis but most likely the problem is a common and unconcerning diagnosis, like diarrhea from a stomach bug. But I am often left wondering if my clients are disappointed in my matter-of-fact approach to their care.

The Damaging Effects of Information Overload & Stress

Women are unaware of the effects of panic and chronic worry on the health of their pregnancy. The baby will begin to develop chemical defense mechanisms in utero to survive in the world of his mother. Because the fact is, if a woman is stressing while the baby is in utero, it will be way worse once the baby is out. There is increasing data to support the effects of maternal stress on the neurodevelopment of the baby. “The apple does not fall far from the tree.” We are creating generations of people who cannot find peace and trust in their world because their environment is so stressful starting from their intrauterine life.

A preliminary study of pre- and postpartum women and their infants suggests that prenatal stress may cause adverse effects on neonatal development. The study was conducted by Pathik Wadhwa, M.D., Ph.D. and his associates. Dr. Wadhwa concludes that“…there is increasing evidence from both animal and human studies that maternal stress “may play a significant role” in the etiology of intellectual deficits and psychiatric and behavioral disorders, he remarked. The mechanisms underlying these effects are partially mediated by maternal stress hormones and consequent changes in “the set points of developing neurotransmitter systems in the fetus,” said Wadhwa. psychnews.org/pnews/98-05-01/stress.html

Midwifery, A History Of Trust

Midwifery has a history of trust. Trust in the woman’s body and in her fetus to grow and birth, strong and healthy. Trust in the ancient Art of Midwifery to guide and support the woman through the challenges of pregnancy and birth and mothering. The internet is destroying the faith that we used to easily achieve with our clients. We gained her trust by having knowledge and wisdom that we applied to the client that sat before us. The trusting, relaxed Earth mother rarely walks through our door these days. She has been replaced by a high tech mama who wants what we do because she has read on the INTERNET that she should. She is not, however convinced that we can be trusted without consulting her internet MD too.

Beyond Information, the Human Element

I do not consider myself the expert that the Internet Doctor is. I do not claim to know everything about pregnancy, birth, breastfeeding and gynecology that this huge “physician” knows, but I know my client. I am able to evaluate her with my senses and with my intuition and my knowledge. I have tried different approaches to all problems over the years of dealing with hundreds of women and I have developed an ability to care for different women in different situations. I can see when I am scaring a woman with the information I am giving and re-phrase myself. I can give hugs and reassurance and encouragement which the indifferent, information-spewing Dr. Internet cannot. I am confident that I offer what women want and need in a care provider. I am just hoping to convince them of the same.

The message I am trying to convey is that being a healthcare provider is not just being a container of knowledge and information. We add discernment, wisdom and love to the mix. The Internet can’t do that!