William E. Morgan, D.C.

This is a familiar situation for most doctors:  Your waiting room is full and you are twenty minutes behind schedule when you walk into a treatment room only to be confronted by a patient with a lap full of internet printouts regarding various health concerns.  Your favorite “cyberchondriac” has a few questions about some reports from the internet.   “According to this report I have the symptoms of Lyme Disease.”  (Of course Lyme Disease could be substituted with hypothyroidism, Valley Fever, lupus,  fibromyalgia, MS,  chronic fatigue syndrome or any of a number of conditions with indistinct presentations.)  You weigh your options.  Do you dismiss the patient’s concerns and just treat the visit as a routine chiropractic treatment?  Or do you sit down and answer every question the patient has and ruin your schedule?

The best answer is one that does not dismiss their concerns, but also does not interrupt your schedule.  You may choose one of these schedule saving strategies [i].

• Get their telephone number and call them during a lull in patient flow.
• Have them schedule another office visit to discuss their questions.
• Have them wait in your office for a quiet period to address their concern.
• Interact with them via the internet.

The information age has changed everything in our society, including the doctor-patient relationship.  Certainly a major trend in western society is to turn to the internet to gather information about health issues.  However, it is frustrating to the doctor when the patient becomes self-absorbed and obsessed with the results of internet searches, or attempts to manipulate the doctor into ordering expensive and unnecessary tests.

One study, the Pew Internet & American Life Project, revealed that 113 million Americans, representing 80 % of internet users, search the internet for healthcare information.  Disturbingly 6% of those surveyed searched the internet for health information everyday.  While the internet is empowering for most patients seeking health related information, to a true hypochondriac the internet is a living nightmare: an endless quagmire of information and misinformation that they are obsessed to search. This type of compulsive behavior can be as debilitating to a patient as a physical disease.  Though hypochondriacs are frequently lampooned by the media and even healthcare providers, this condition is a serous concern.

In managing patients with hypochondria the tendency is to assume that there is nothing physically wrong with the patient.  Before making this assumption insure that the patient really does not have a serious disease.  Do not tell a hypochondriac that nothing is wrong; this is not reassuring to hypochondriacs. Coax patients with health anxiety toward healthy life options such as proper sleep, exposure to sunlight and fresh air, avoidance of unnecessary drugs, exercise, healthy eating, smoking cessation, temperance, healthy socialization, and maintaining a daily routine.  Also encourage them to resist compulsive internet searches. Patients with health anxiety should have periodic scheduled doctor visits, not impulsive sporadic care.  Finally if the patient’s compulsiveness surpasses the point of being just quirky to becoming obsessive, refer the patient to a behavioral health specialist.