Last week I watched “Embarrassing bodies” online. In this popular 2007 documentary-style series, Dr Christian Jessen and Dr Dawn Harper help patients with neglected health problems. Of course it’s only a TV show, but it draws attention to the fact that embarrassing illnesses can leave many people.
Recently I’ve noticed some strange changes on my skin and I don’t know what they could be. It worries me a lot. Has anyone had anything like this, and can you tell me what I should do? What is it? Please help.” The Internet is full of posts like this. Medical websites, Facebook pages and specialized patient portals have become places where anyone can seek support and find answers to health problems. Unfortunately, the advice and opinions come not from those who have appropriate knowledge, but from people we trust and who have the same problems, namely fellow sufferers. Why do some people prefer to diagnose themselves on the Internet instead of going to the doctor? Why is this trust more important than professional knowledge?
From rashes, varicose veins or athlete's foot to serious sexually transmitted diseases and mental disorders, there are hundreds of ailments which patients would prefer not to share with doctors. They have many reasons: stigma, fear of judgment by the doctor, lack of sympathy from doctors in the past, or the desire to keep a secret in a small town or village where everyone knows each other. A patient with an itchy rash in an intimate area may try to deny that the cause is an STD. In this case, diagnosis by a doctor can mean having to admit a shameful story about one’s private sex life and irresponsible behavior. Thoughts like “What if someone else finds out?”, “I can’t admit to being so irresponsible” or “I have a family and I have to keep this a secret” are sometimes so strong that patients choose to suffer rather than look for professional help.
A person who constantly feels sad and isolated from society may try to explain it as ordinary sadness for which there is no need to see a doctor. While seeing a psychiatrist and being diagnosed with depression is no longer a problem in big cities, the threat of being stigmatized is still high in small communities. Many of us have a deep-rooted conviction that if it's not life-threatening we shouldn't bother the doctor, and if it’s embarrassing we have to avoid the doctor.
“Many prefer to suffer rather than expose their secrets face-to-face. From this state of mind, the patient enters a tunnel of isolation and fear”
“Many prefer to suffer rather than expose their secrets face-to-face. From this state of mind, the patient enters a tunnel of isolation and fear”.
Personalized medicine promises better treatment. We should also consider personalized healthcare, so that everybody gets help in their preferred way, time and place. Symptom checkers do not replace doctors, but they do offer real help, such as when people are ashamed or embarrassed to see a doctor in person. Instead of blaming patients or trying to force them to change their behavior, it’s much more effective to understand them and provide them with a suitable tool. Modern technologies in the form of symptom checkers make this possible.