I didn't, although I did have menstrual cramps! This I learned from an actual, human doctor, who wearily suggested that I not consult the Internet to identify symptoms anymore. "It makes our jobs harder...well, and easier," she conceded. Because at least there's also an upswing in people feeling really relieved when they find out they've mis-diagnosed themselves!

Says the Telegraph, "Increasing numbers of people (48 per cent) say that they have used the internet to find out more about an illness according to a report by Ofcom, the media regulator. The research found women are more likely to do so, with 53 per cent admitted to looking online for medical advice, in a trend has become known was ‘Dr Google'."

Please, Dr. Google's a charlatan. All the best people go to Dr. WebM.D.'s practice. Hello, he's an M.D.! But, oddly enough, the same survey found that the diagnoses left people "worried and confused." Okay, hypochondria aside, there are times when I've found web-related medical stuff helpful: message boards and FAQ pages for birth control and medication's side effects, a migraine support group that made me feel like I had it easy! In these cases, the sense of not being alone, of finding out that things were normal, was indeed comforting. And obviously, the net is a font of homeopathic wisdom!

The problem, of course, is when it enables hypochondria. All those "see a doctor immediately" advisories are probably legally advisable - and if they've forced anyone to take something deadly seriously, well terrific. (And you can't help thinking a little light web-surfing might have been a good idea for some of those "I Didn't Know I Was Pregnant" dames TLC is always rounding up.) But I'm guessing the vast majority of people with something very wrong know something's very wrong. And if they're not the sort to go running to the net for the slightest sniffle, chances are they'll be calling a doctor with the other hand anyway. The problem, too, is that it's very tricky to actually tell what's wrong from listing symptoms - most of which can presage something serious anyway. Is there anything really wrong with self-diagnoses? Well, not, I suppose, if you get a real second opinion - ergo, if you have great insurance. Otherwise, yes, reading that you might - or might not! - in fact have meningitis is indeed pretty stressful. As my doctor said, "a little knowledge is a dangerous thing." Or at least, annoying.

Half Of Women Are Diagnosing Themselves Online, Says Ofcom [Telegraph]

In a piece off-puttingly titled "The Tell-Tale Womb of Lewiston, Maine," NPR talks about the "eureka" moment (or, you know, the bad equivalent) for Dr. Jack Wennberg, whose work has become an important cornerstone of the healthcare-reform debate. In the 1960s, charged with bringing modern methods to isolated New England communities, Wennberg started examining the existing practices, studying every medical record in the state of Vermont. What he found was shocking and bizarre: in some towns everyone had their hemorrhoids removed, in the next town, not; in one town 3/4 of the kids were missing tonsils, while just down the road their neighbors' were in tact. As to Lewiston's hysterectomy mania, well, Wennberg quickly deduced that it was not, as people had always assumed, because the largely Catholic community had more children than others. Rather, it was all the doctors, and it was arbitrary. So Wennberg started getting doctors together and talking with them.

One reason some doctors mentioned was fear of lawsuits; some worried that if they didn't do every possible thing they might get sued. Another reason was temperament - some doctors were clearly just more eager to take action than others....Then there was the role of local medical culture. For example, even though it didn't make sense and wasted a lot of time and money, pediatricians in some communities felt they absolutely positively had to send even mildly sick kids to the hospital.

Doctors were also affected by "peer pressure" from other practices, and, the elephant in the room, money. Simply put, if you do more, you charge more. More procedures, more complexity, is more lucrative. It is not always, surely, malevolent - and generally it doesn't seem, from the piece, like it's doing (overt) "harm" - but it's also true that this may affect why some procedures become industry standard while older ones are phased out. That, and our appetite for innovation and the mind-set that complicated is good - and expensive is good. What's funny about the findings is that wealthier patients - although they got more care - were not necessarily living any longer. Explains the piece,

This is probably because of a something called fragmentation of care. In high-use areas, it's often the case that many different doctors play a role in the care of a patient; many specialists are responsible for overseeing only a small part of the person. This increases the amount of treatments, tests and hospitalizations that people get, and exposes people to more risk of harm from medical error and side effects.

NPR concludes "the United States spends more than $2 trillion on health care every year. So the cost of that 30 percent unnecessary care annually? $660 billion." This is black-and-white and inarguable. But Surely within that there's plenty of gray - the forementioned community expectations, that'll be a major overhaul, plus the fact that an "unnecessary procedure" that brings comfort to a dying person or his family is a trickier matter than a wholly gratuitous hysterectomy. And the role of malpractice reform, only mentioned in passing here, seems important: if in fact fear of lawsuit and untenable insurance policies are pushing doctors to do more - to do everything - rather than an intuitive safer "less," it seems like an unavoidable piece of the puzzle. The upshot (besides the fact that, yes, we really need some health-care reform)? Second opinions, people. Ideally? Over the town line.

The Telltale Wombs Of Lewiston, Maine [NPR]

In his blog, The White Coat Underground, internist PalMD takes Oprah to task for her claim that, "homeopathy treatment is similar to how a vaccination or immunization works." He counters, "You can measure the antibody response provoked by a vaccine. You cannot measure anything provoked by homeopathy because the only think homeopathy produces is a bill." To Oprah's admission that, "there are different theories behind homeopathy. But lack of convincing evidence is a big concern with homeopathy's acceptance by conventional medical doctors," PalMD responds,

No! Homeopathy's "lack of convincing evidence" is not some problem we uptight "conventional doctors" have—-it is the fundamental problem (along with the absurdity of it) with homeopathy. It has not been shown to work. This is rather important in medicine.

Newsweek's critique is more far-reaching. Writers Weston Kosova and Pat Wingert call Oprah out for her embrace of Suzanne Somers's potentially dangerous "biodentical" hormone regimen, Jenny McCarthy's potentially dangerous argument that vaccines cause autism, and Rhonda Byrne's The Secret, which is potentially dangerous if you, like Oprah's guest Kim Tinkham, take it to mean that you should use positive thinking instead of actual medicine to cure your illnesses. Oprah is in a unique position, they write:

Her most ardent fans regard her as an oracle. If she mentions the title of a book, it goes to No. 1. If she says she uses a particular wrinkle cream, it sells out. At Oprah's retail store in Chicago, women can purchase used shoes and outfits that she wore on the show. Her viewers follow her guidance because they like and admire her, sure. But also because they believe that Oprah, with her billions and her Rolodex of experts, doesn't have to settle for second best. If she says something is good, it must be.

Oprah told ET Online that "I trust the viewers, and I know that they are smart and discerning enough to seek out medical opinions to determine what may be best for them." And in a longer statement released to Newsweek, she said,

The guests we feature often share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them. I've been saying for years that people are responsible for their actions and their own well-being. I believe my viewers understand the medical information presented on the show is just that-information-not an endorsement or prescription. Rather, my intention is for our viewers to take the information and engage in a dialogue with their medical practitioners about what may be right for them.

But the truth is, many do look to Oprah as an oracle. She had far too much power to pretend that her excitement over certain treatments ("After one day on bioidentical estrogen, I felt the veil lift," she wrote in her magazine) is just more information or people to consider. Oprah's opinion is persuasive to many people, more persuasive, perhaps, than the advice of their own doctors, and she has a responsibility not to recommend that her viewers sacrifice their money and possibly their health for treatments that have no scientific basis.

Kosova and Wingert say Oprah hasn't given equal weight to critics of Somers or McCarthy's positions. She read a statement by the CDC denying the link between vaccines and autism but then allowed McCarthy to conclude the segment. McCarthy said, "my science is named Evan, and he's at home. That's my science."

Health is unpredictable and scary, and it's natural to want to rely on "my science," to crave a certain feeling of control. Oprah offers that control, telling viewers, "we have the right to demand a better quality of life for ourselves. And that's what doctors have got to learn to start respecting." But this control is an illusion. We can't demand better health from our doctors, from supplements, or from the universe. At some point, we have to take what comes our way. Oprah's message of "living your best life" has been helpful to many people, but sometimes your best life comes from accepting your lot, and looking at your options with a clear, critical eye.

Live Your Best Life Ever! [Newsweek]
Oprah's Website Of Woo—-Can It Change? [ScienceBlogs]
Oprah Responds To Newsweek Report [ETOnline]