Suffering from cyber-chondria?

Feeling a bit funny?  Worried about those lumps and bumps?  Got a strange collection of symptoms which don’t seem to add up?  Yes you may need to consult your doctor, but you should also be prepared to be told that you are suffering from a newly identified disease which according to a recent study is costing the NHS at least £420m a year.

The study looked at the causes and effects of cyber-chondria which the researchers say could be the underlying reason for as many as 1 in 5 of hospital outpatient appointments.  As Prof Peter Tyrer, one of the authors of the study, explained “Dr Google is very informative, but he doesn’t put things in the right proportion.”

Cyber-chondria does create a dilemma for the health profession. On the one hand, we are being asked to reduce the burden on the NHS by self-treating minor ailments or consulting local pharmacists in the first instance. On the other hand, a propensity to misdiagnose the causes of symptoms following an internet search could either lead to unnecessary appointments or to patients not presenting at their GP surgery when early treatment for a condition could prevent ongoing problems.

There appears to be no one straightforward answer. And it’s certainly true that when someone presents with a range of symptoms, some may be related to a genuine ongoing illness, whilst others can be laid at the door of health anxiety. Ignore all the symptoms and the chance for early intervention can be missed, treat all symptoms as potentially genuine and hospital referrals increase significantly. So awareness and proportionality, knowing your patient, can play a significant role in sifting illness from the cyber-chondria maze.

That’s not to say that cyber-chondria isn’t an illness in its own right. Indeed the report’s authors suggest that for those suffering from acute forms of health anxiety, some form of psychotherapy may be in order. And as with any other illness; the earlier the treatment, the better the prognosis.

This approach was borne out in another field recently when the results of a back pain pilot were released.  The pilot run by a primary care service in Hertfordshire saw a physiotherapist with spinal expertise triaging and providing advice to patients who self-referred to a clinic.  With further expertise available as a back up and the ability to directly book ongoing treatment the experiment saw 85% of patients discharged after a first appointment.  Moreover, on the spot advice on exercise and rehabilitation meant that only 3.5% of patients needed to be referred to secondary care as opposed to a 12% GP referral rate.

The main message which arises from studies such as these is the importance of early intervention when treatment is required.  In a health system which is seeing an ever increasing demand for its services this isn’t always easy. However, even little tweaks to processes and procedures can make a measurable difference to boosting patient treatment times. Even something as simple as SMS text messaging which reminds patients to attend appointments can not only boost early treatment, it can also ensure that treatment times are fully utilised.

Of course, there are times when the chance for early intervention has been missed and the mantra ‘better late than never’ comes into play. We are indebted to the Jewish Chronicle for highlighting just how effective physiotherapy can be. Four years ago, Ann Rowe was wheelchair bound and dependent on hoisting equipment. Now, thanks to intensive physiotherapy, at the age of 87 she has completed the Parallel London 5k event.

Early treatment, late treatment, ongoing treatment; what this story and others show is that when health professionals are freed from administration and able to do what they do best, providing good and targeted therapies, great things can happen.