Abstract
Background:
Contemporary medicine has expressed concern about lay incursions into the diagnostic process buttressed by commonly available medical information on line. Even while the world wide web is a new structure, there is a long historical precedent for this concern. With the emergence of scientific medicine in the late 19th century came a strong belief in the role of diagnosis, not only to explain disease symptoms but also to differentiate the physician from a range of other unreliable practitioners. Along with this focus on diagnosis came also a concern expressed by doctors about patients’ inclination to self-diagnose, or to propose candidate diagnoses for the problems that ailed them.
Methods:
This paper uses Zerubavel’s social patterning method. Using material written by doctors from the late 19th until the mid-20th century, I explore comments about, and attitudes towards, self-diagnosis.
Results:
Three areas of concern about self-diagnosis are expressed by doctors. First, self-diagnosis produces anxiety in the patient. Second, it interferes with doctor-patient relationship. Finally self-diagnosis is commonly linked to commercial interests.
Conclusions:
Contemporary concerns about self-diagnosis are part of an ongoing social pattern, which simultaneously promotes diagnosis as means for explaining disease but also protests when the diagnostic explanations originate with the patient.
Author contributions: The author has accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Crenner C. Private practice in the early twentieth-century medical office of Dr. Richard Cabot. Baltimore: The Johns Hopkins University Press, 2005:303.Search in Google Scholar
2. Hadra BE. The public and the doctor. By a regular physician. Dallas, Texas: J.M. Colville, The Franklin Press, 1902.Search in Google Scholar
3. Zerubavel E. Generally speaking: the logic and mechanics of social pattern analysis. Sociol Forum 2007;22:131–45.10.1111/j.1573-7861.2007.00010.xSearch in Google Scholar
4. Avery N, Ghandi J, Keating J. The ‘Dr Google’ phenomenon – missed appendicitis. N Z Med J 2012;125:135–7.Search in Google Scholar
5. Feke T. Dr. Google should be sued for malpractice. Here’s why KevinMd.com2015 [cited 2016 20 Oct]. Available from: http://www.kevinmd.com/blog/2015/08/dr-google-should-be-sued-for-malpractice-heres-why.html.Search in Google Scholar
6. Hesse BW. The patient, the physician, and Dr. Google. Virtual Mentor 2012;14:398–402.10.1001/virtualmentor.2012.14.5.stas1-1205Search in Google Scholar
7. Limb M. Technology must not replace human contact in drive for self care, conference hears. Br Med J 2014;348:g4278.10.1136/bmj.g4278Search in Google Scholar PubMed
8. Tyrer P, Eilenberg T, Fink P, Hedman E, Tyrer H. Health anxiety: the silent, disabling epidemic. Br Med J 2016;353: i2250.10.1136/bmj.i2250Search in Google Scholar PubMed
9. Doherty-Torstrick ER, Walton KE, Fallon BA. Cyberchondria: parsing health anxiety from online behavior. Psychosomatics 2016;57:390–400.10.1016/j.psym.2016.02.002Search in Google Scholar PubMed PubMed Central
10. Fergus TA, Dolan SL. Problematic internet use and internet searches for medical information: the role of health anxiety. Cyberpsychol Behav Soc Netw 2014;17:761–5.10.1089/cyber.2014.0169Search in Google Scholar PubMed
11. Kim H. Trouble spots in online direct-to-consumer prescription drug promotion: a content analysis of FDA warning letters. Int J Health Policy Manag 2015;4:813–21.10.15171/ijhpm.2015.157Search in Google Scholar PubMed PubMed Central
12. Lupton D, Jutel A. ‘It’s like having a physician in your pocket!’ A critical analysis of self-diagnosis smartphone apps. Soc Sci Med 2015;133:128–35.10.1016/j.socscimed.2015.04.004Search in Google Scholar PubMed
13. Krecke A. The doctor and his patients. Lange F, editor. London: Kogan Paul, Trench, Trubner, 1934.Search in Google Scholar
14. Anonymous. Commerce without conscience. Br Med J 1937;24:178–9.10.1136/bmj.2.3994.178Search in Google Scholar
15. Gersuny R. Doctor and patient: hints to both. Bristol, UK: John Wright & Co, 1889.Search in Google Scholar
16. Keith RD. Clinical case-taking. London: H.K. Lewis & Co. Ltd., 1918.Search in Google Scholar
17. Lapham RF. Disease and the man. New York: Oxford University Press, 1937.Search in Google Scholar
18. Styrap J. A code of medical ethics: with remarks on the duties of the practitioners to their patients, and the obligation of patients to their medical advisers. London: J & A Churchill, 1878.Search in Google Scholar
19. Bainbridge WS. The Cancer Campaign Quarternary: the problem; the public; the patient; the physician. Am J Surg 1917;31:162–7.Search in Google Scholar
20. Little EG. Doctors and the public: an address delivered at the opening of the medical session at St. George’s medical school on October 1st, 1926. Foxton: Burlington Press, 1926.Search in Google Scholar
21. Brackenbury HB. Patient and doctor. London: Hodder and Stoughton, 1935.Search in Google Scholar
22. Rector FL. Seven steps to the undertaker. Bull Am Soc Control Cancer 1936;18:1–5.Search in Google Scholar
23. Kreimer S. Dealing with Dr. Google: why communication is key ModernMedicine Network 2015 [cited 2016 20 Oct]. Available from: http://medicaleconomics.modernmedicine.com/medical-economics/news/dealing-dr-google-why-communication-key?page=full.Search in Google Scholar
24. Goyder C, McPherson A, Glasziou P. Self diagnosis. Br Med J 2009;339(nov11_1):b4418.10.1136/bmj.b4418Search in Google Scholar PubMed
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