The Doctor is ... YOU! Online Medical Symptom Checkers Examined
My take: I couldn't figure out the point of this site's name. It functions like the others in providing a symptom checker and many other kinds of information, and it includes a "Misdiagnosis Center" that lists commonly misdiagnosed diseases. But I couldn't tell if its intent was to correct misdiagnoses or publicize the problem or what.
Anyway, the symptom checker boasts 10,000 medical conditions. It takes the list approach instead of an interactive map and lets you choose from common symptoms, browse alphabetically or pick from a full list of more than 3,000 symptoms.
I went to the alphabetical section and clicked on "heel pain." Sure enough, plantar fasciitis was listed as No. 5 of six causes. Three matched WebMD's 15. Adding many different second symptoms didn't result in any lists with plantar fasciitis.
Dr. Beaty's take: She found WrongDiagnosis.com to be "more geared toward the medical community, so I'm really not sure how a layperson would use that too well."
For example, she said that the urinary symptom pulled up 152 possible causes, and when you tried to limit them via the symptom checker, "you ended up finding things like urinary pain with acute Crohn's symptoms ... and you went through the whole diatribe of just really bizarre medical conditions that most people wouldn't even know. So unless you had a medical background, I don't see how that site would be useful for people at all."
Dr. Spooner's take: He said WrongDiagnosis.com "really feeds that need to find rare diseases. For some situations, that may be appropriate." For the general public, though, he said, "I wouldn't encourage people to go to WrongDiagnosis because it kind of overwhelms you with strange things."
He said a search of headache and bowel problems resulted in 268 possible conditions. The other sites, he said, do "a good job of putting up different guardrails so you don't go off on tangents." But here, for example, a bizarre condition called "arctic bearded seal syndrome" came up in a long list of results from one search. "I don't know how you would even process this," he said.
The final say
So here's the summary of how many clicks it took me to get a list of possible causes that included plantar fasciitis. These are the shortest routes I eventually found to get to the end result, often after several earlier attempts where questions were confusing and I ended on a page with no plantar fasciitis.
- WebMD: 12 clicks to get a list of 15 possible causes
- Revolution Health: 2 clicks to get a list of 13 possible causes
- MayoClinic.com: 5 clicks to get a list of 7 possible causes
- About.com: 9 clicks to get a list of 3 possible causes
- WrongDiagnosis.com: 1 click to get a list of 6 possible causes
So About.com narrowed down the list to the fewest number of possible causes, but WrongDiagnosis.com got to its final list quicker than any other site. There were surprisingly few common possible causes among the sites.
For my particular problem, About.com was the most useful because it asked the crucial question about initial pain experienced after getting up in the morning that decreases as you walk around. That's a classic symptom of plantar fasciitis and really focused in on my condition. Your mileage may vary.
Dr. Beaty's general observations about symptom checkers were mixed. "It's sometimes useful, I think, for patients to gain some information before they come in. But more often than not, it ends up wasting the doctor's time because they have to spend more time educating about why it's not certain conditions rather than just kind of dealing with the patient and the problem that they present and focusing on that."
She said patients often come in with printouts from magazine articles or other Web research about what their condition could be and ask, "'Why aren't we ruling out this?' when it's something like a urinary tract infection, which is very obvious. And then they're looking at it and getting 16 different options and wondering why we're not ruling out various pelvic pathologies like ovarian cancer."
It's not uncommon to see one or two patients a week with such printouts, she said. Patients coming in armed with information from the symptom checker sites are fewer, she said, averaging perhaps one or two a month.
She agreed with the Microsoft report that Web searches tend to escalate patients' fears. "Absolutely, just like when we were all in medical school, we all felt we had each thing that we learned about. It is human nature.
"It does make it a little bit more difficult as a physician. Once again not that it's more difficult for us to figure out what's going on, but then we have to deal with the misconceptions that the person walked through the door with."