I’m going to tell you a little secret about modern medical practice that most doctors know, but most patients don’t: Doctors rely on Google and Youtube all the time to look stuff up. I recently sat at a physicians-only area of a hospital, when I overheard one doctor asking a colleague, “How do you perform a such-and-such procedure?” The other immediately replied in all seriousness, “Just Youtube it!” This happens every day in hospitals across the country. Similarly, I (and colleagues) use Google all the time to look up subtle details of diseases, side effects of medications, and lists of possible conditions that might cause certain abnormal findings on MRI and CT scans. I’ve also used Youtube on multiple occasions to refresh my memory on the details of procedures I might not have performed in a while. So how worried should patients be that their physicians get medical information from Youtube and Google? As the old joke goes, “There’s a lot of great information on the Internet — and some of it is even true!” A common internet search for symptoms. SCREEN CAPTURE (PUBLIC DOMAIN) A recent article by CNBC technology reporter Christina Farr ominously warns, “Doctors are turning to YouTube to learn how to do surgical procedures, but there’s no quality control.” There are thousands of online videos that demonstrate how to perform various invasive and surgical procedures in graphic detail. Farr observes: The videos are a particular boon for doctors in training. When the University of Iowa surveyed its surgeons, including its fourth-year medical students and residents, it found that YouTube was the most-used video source for surgical preparation by far. And it’s not just young trainee physicians using these videos. Experienced surgeons often consult them for guidance. Yet these videos don’t always contain reliable information. Farr notes: “A group of researchers found that for a surgical technique called a laparoscopic cholecystectomy, about half the videos showed unsafe maneuvers.” From my own experience, I’ve found that videos demonstrating procedures I’m already familiar with to be of mixed quality, varying from superb to adequate to abysmally bad. I assume this is holds true for videos covering branches of medicine I am less familiar with. So how do good doctors make the best use of all this online information? Based on my own experience as well as talking with colleagues, we tend to adopt the following guidelines before using information from a Youtube video: 1) We check the source. Is the video from a established physician whose credentials we can verify? Is the video author affiliated with a reputable medical school or medical center? Have they published articles in the regular medical literature that establishes their expertise in the subject? Or are they just “some guy”? 2) We see if the content fits with our pre-existing medical knowledge. Do the details illustrated by the video adhere to standard “best practices” for good surgical technique? Do they make good sense from an anatomic and physiologic perspective? Do they include good tips on things to do (or not do) during the procedure? For example, I’ve viewed many videos on ultrasound-guided invasive pain management procedures, which is an area I’m already familiar with. The good videos typically include detailed discussions of how to identify critical arteries and nerves and “best practices” to avoid injuring those vital structures during the procedure. 3) We double-check the video content with other sources. Even after I watch a seemingly trustworthy Youtube video, I’ll typically run the details past a colleague. Or I’ll cross-reference them with other available literature on the same topic. In other words, good physicians take what they learn from Youtube and Google and integrate that information with the full context of their prior medical knowledge built upon years of formal training and years of real-world practice. In my opinion, this is how physicians can best “vet” the information they find on Youtube and Google. This is also why physicians can generally sift through medical websites and videos more efficiently than non-physicians who Google their own symptoms. Physicians usually have enough additional background context to find the nuggets of useful information amidst the background noise more efficiently than lay persons — not always, but usually. Furthermore, I don’t think that having a government agency act as a regulatory “watchdog” to approve or reject medical videos would do much good. I can envision medical societies (such as the American College of Surgeons) maintaining a list of approved videos resources they endorse. In matters such as this, I trust independent physicians acting on their own best judgment much more than I trust bureaucrats. If patients are concerned how their doctors are utilizing online information, they should ask their physicians directly. And in particular, patients can ask their doctors what sources they use, what cross-checking methods they adopt, and how they compare with the guidelines above. Overall, I’m glad there’s a proliferation of medical information online, in forms that are easy to locate and evaluate. Youtube and Google have allowed me to find helpful information directly applicable in daily practice much faster than back in the 1990s, when I used to have to drive to a medical library and look up paper articles in heavy bound volumes on the shelves. Just as modern technologies help drivers find their way to unknown destinations more efficiently, or help consumers find the best shopping deals more easily, they can help physicians take care of their patients more effectively. Physicians have to use reason and good judgment when evaluating these new sources of information — just as they have had to for centuries. When used properly, resources like Youtube and Google help make me a better doctor, and I’m thankful they exist. Source
