The Reality of Open Source Health Advice

Last week someone posted on Twitter that they had swallowed a plastic toothpick.  What to do?  So they turned to the hive for help.

“What should I do?” I thought as I read my Twitter feed.  I was paralyzed in a way.  I wanted to share my experience with hundreds of patients had swallowed pins, toothpicks and other pointy things.  I specialize in just this sort of thing.

But short of a random comment about gastric emptying, I kept to myself. 

Why?  Because once I lend a hand I’m all in.  The simple offer of patient-specific advice constitutes a relationship in the eyes of the law.  Once involved, I potentially share responsibility in whatever happens to someone.  Crazy but true.  It’s just a matter of time before slip-and-fall lawyers hold physicians accountable for helping out in the social sphere.

Doctors aren’t the only ones wearing targets.

In the virtual land grab to get a piece of the chronically ill we’ve witnessed the growth of a cottage industry composed of alternative providers.  I suspect that well-insured health sites providing safe harbor for mavens, disease experts, gurus, advisors and other self-anointed authorities will at some point feel the sting of the trial bar. 

Attorneys and gurus aside, health professionals need to worry about doing the very best for those looking for help.

Here’s a thought:  Unless a practitioner has the critical details of someone’s current complaint, a complete history, record of medications/allergies, a medium by which crystal-clear communication can be exchanged and a reproducible record where it can all be recorded, it’s risky and potentially irresponsible to offer passing medical advice.

That’s the kind of advocacy you won’t hear much about.

The heady exuberance of open source medical advice will play itself out.  The market’s never wrong.  Good, responsible care, however, will never go out of style.

And one last thing:  What if you know I read about the toothpick and failed to lend a hand?  Let’s not go there…

Comments

[Susannah Fox]

I'll confess it: I posted about the toothpick.

A friend called me from the road, a little panicked, knowing that I was near a computer and could quickly search for "what to do when you have swallowed a plastic toothpick." I did the search and then left voicemails for my two best friends, who happen to be MDs (one is an internist, the other a hepatologist).

Then I sat staring at my computer screen at these links:

http://www.justanswer.com/questions/1a5r8-accidently-swallowed-plastic

http://www.general-health-care.com/generalhealthcare/a211175.html

http://www3.interscience.wiley.com/journal/112167552/abstract?CRETRY=1&SRETRY=0

http://emedicine.medscape.com/article/776566-overview

I hesitated to post to Twitter for many of the same reasons why DrV hesitated to answer: what will it mean when I get back the replies? But my friend was panicked and I wanted to help, so I posted. The replies I got lined up with what I saw in the search results AND what I got from my hepatologist friend: if there is no pain, let nature take its course since there is a very good chance the toothpick will pass on its own.

Hopefully no harm, no foul in the social media space. So far no harm (but, sorry about this) lots of foul in my friend's case.

[DrV]

Thanks for your response, Susannah. And all's well that ends well. This issue of liability isn't talked about much but I think it'll see the light of day when more healthcare professionals make their way to the social media space.

It's actually really sad that felt reticent about telling you my two cents worth on intestinal foreign bodies.

I might suggest our legal system invoke some sort of diplomatic immunity for professionals offering a hand!

[twitter.com/mkmackey]

Disturbing to me that so called "innocent" casual medical responses could ultimately do harm and most disturbing is that the community most able to give medical help and opinions in an emergency is not even consulted.

[DrV]

Kathy - Innocent responses shouldn't represent a relationship. And it's unlikely that a jury would see it that way. Plaintiff attys, however, are quite liberal as far as holding folks accountable ... even when they're only peripherally involved.

[DrV]

Received word last night that the toothpick in question is free.

[John Grohol, PsyD]

I've seen doctors and other healthcare professionals giving patient-specific advice for 20+ years online. I know of zero instances where a professional has been sued for the advice they've given in such cases.

So while it is indeed an interesting hypothetical situation, the data suggest it is not something to be overly concerned about -- especially for quick, general answers that can be just as readily Googled.