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Wednesday, September 26, 2012

How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac

September 26th, 2012Top Story

How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac

By Alan Henry

How to Get Reliable Medical Information on the Internet Without Turning Into a HypochondriacGetting sick seems a lot more stressful now that we have the internet. You can research your symptoms, but inevitably you'll fall down a rabbit hole of illnesses that are so unlikely, every search will turn up a life-threatening disease. It is possible to get reliable, useful information, vet it properly, and even get an expert opinion, all online. Here's how.

Before we begin, a disclaimer: We're not doctors. We spoke to several for this story, but don't think you'll be able to walk away from this post able to diagnose your own symptoms. Our goal is to help you find reliable sources to turn to when you have minor aches and injuries, and give you an idea of what's up if you can't get an appointment right away. Keep in mind though, if diagnosis were easy, doctors wouldn't have to train so long to learn how to do it. If you have a serious condition or don't know what's going on, always consult a doctor as soon as possible.

Beware Dr. Google: Most Web Sites are Terrible at Diagnosis

How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac We all know what it's like: you have an ache you're not familiar with, or a bruise suddenly appears and you have no idea where it came from. You fire up Google and type in the symptom, as specific as you can make it, and you're instantly overwhelmed by the dozens of possibilities, keywords, illnesses, and other scary terms. Unfortunately, no site can diagnose an illness based on symptoms that you type into a search box. Sure, you probably know if your stomachache just happened to set in a few hours after visiting the oyster bar, but keep in mind that a heart attack can have symptoms very similar to a bout of bad indigestion, and it can be difficult even for trained and experienced professionals to tell the difference without equipment or specific tests.

Every doctor I spoke to for this story warned against using Google for diagnoses, and noted that the world of medical information on the internet will just make you crazy with wonder if you search blindly. No one wants to sit in the dark at their computer at 2am wondering if the ache in your leg is a pulled muscle or a pulmonary embolism when one site says to rub some athletic cream on it and go to sleep while another says you need to go to the ER immediately. So what do you do instead?

Search Smart, and Use Interactive Doctor/Patient Services That Really Help

How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac Scatter-shot symptom searches are almost always a bad idea, but there are some services and sites that are better than others. In most cases though, a cool head is much more valuable than a page full of scary search results. When you're struggling with symptoms, here are some important things to remember:

  • How confident are you that this is minor/major? There's no foolproof way to tell a minor issue from a major one, but things like pain or discomfort level can help. Try to stay calm, especially if the symptoms are unfamiliar, and think things through. Is it getting better or worse? Have you experienced this before, and how does this time compare? If you think the issue is major or don't know what you're dealing with, seek professional help. If the issue is minor, remember that as you research, so you don't get carried away.
  • Search with Occam's Razor in mind. Several of the doctors I spoke to mentioned that some patients wind up panicking because they dug up search results that aligned with their symptoms, but were so unlikely that they're almost never correct. This is one of the biggest issues with searching by symptom on the web: someone with a bad cold may come away thinking they've come down with dengue flu just because the symptoms may be similar. Remember, common conditions are the most likely ones (eg, a sprained ankle not a broken one, or a headache not an aneurysm.) Still, leave diagnosis to the pros: see a doctor so they can look you over and run tests if necessary—just be open to the fact that whatever you found online may not be the issue at hand.
  • How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac Learn to tell good medical sources from questionable ones. This point comes up frequently in the Quora thread we mentioned earlier, but it's critical. Healthfinder.gov, The Mayo Clinic, Medpedia; they're all great sites, but those sites are good because their articles and other content written by, vetted, and reviewed by actual medical professionals before they're published. When you're reading about the symptoms you're experiencing, make sure the information was written or at least reviewed by a doctor, and you're not reading the comments of an otherwise informative article or some user forum where everyone's a self-proclaimed doctor.


    Also, make sure the doctors you're reading are experienced in the areas you're researching—a nutritionist can tell you how to eat well, but they can't tell you if your twisted ankle needs heat or cool to get better. Stick to established, trusted sites with authoritative voices, and when in doubt, print out what you're reading and ask your own doctor for a final say. Remember, nothing you read on the internet is a substitute for real, in-person analysis by a physician. It can be informative and useful as a way to talk to your doctor, but never the final word.

  • Use a service run by doctors that connects you with doctors. A number of new services and apps have appeared recently to combat this issue. One of the leading services is HealthTap, a service we've mentioned before that even has mobile apps to connect you with doctors on the go. One of the doctors I spoke to uses HealthTap himself to connect with people looking for help and offer guidance based on the information they provide—and of course to suggest they see a professional when necessary. The app has a database of questions asked by patients and answered by doctors who have signed up to help, and if you find a doctor you like, you can follow them to see more questions they answer, or communicate with them directly. The app even helps you find a doctor in your area and make an appointment.


    HealthTap really shines when you have symptoms you want to know about though. Before you ask Dr. Google, the apps "virtual private consultations" allow you to pose your question to a live, on-call doctor, ready to offer their best opinion based on the symptoms, photos, video, or other information you provide. They still cost money ($10 per conversation), but it's still cheaper than many co-pays, and gets a real professional opinion in a short period of time. If you're experiencing something unfamiliar and don't want to go to the ER, or between health insurance providers, it's a useful way to talk to a doctor about what you're going through. HealthTap isn't the only service that puts real doctors on your computer screen or on your smartphone, but it's the best we've seen.

  • How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac Call an Employee Assistance Program (EAP) instead. Instead of taking to the internet with your symptoms, check your health insurance plan (if you have insurance, that is) and see if an EAP is available to you. Many EAPs have 24-hour hotlines you can call with both physical and mental health issues in case you're on the fence about whether you should go back to bed or head to the ER. Usually it's an on-call nurse that'll answer, or an operator who'll hand you off to a doctor or nurse, but it's better than symptom searching. Like HealthTap and similar services, an EAP puts you in touch with a live person who can help. Keep in mind though, all of these services say up front that if your condition is urgent or life-threatening, call 911 or get professional help immediately, don't delay. Photo by Kelvin_Kevin Gan.

Several years ago I fell for the marketing lingo in a commercial for an allergy pill I was interested in. I went to the doctor and explained that I had seasonal allergies, and would love something to help alleviate the symptoms. They wrote me a prescription, but it wasn't for the drug I was thinking about. I asked about that specific drug, parroting their marketing line and asking "are you sure I don't need something for indoor allergies and outdoor allergies?"

My doctor tilted her head and said "You watch too much television," before explaining that allergies are caused by a histamine reaction, and that the source of that reaction—whether it's "indoor" (like pet dander) or "outdoor" (like pollen or mold spores)—is the same, and can be treated with the same class of medications. I felt like an idiot—even more so looking back on it with what I know now—but let my embarrassment be a lesson: you don't want to be an "internet patient," so caught up in marketing language and far-fetched diagnoses that you can't tell a sniffle from internal bleeding, or worse, won't listen to the doctor when they explain it.

After the Diagnosis: Do Your Homework and Ask Questions

How to Get Reliable Medical Information on the Internet Without Turning Into a Hypochondriac With luck, your searches will turn up useful data that you can apply immediately, as opposed to vague diagnoses that leave you rattled and afraid. If the issue is minor and you can treat it at home, great—if you see a professional, let them know what you turned up in your searches, and ask for their opinion. Once you have a real diagnosis, you can Google a bit more freely. Photo by wavebreakmedia (Shutterstock).

Many of the sites we've mentioned, like Healthfinder.gov and Medpedia are great for looking up conditions and prescriptions after you've been to the doctor. For example, if your doctor says you have gastroesophageal reflux disease (GERD) because you've been waking up with heartburn every other night for the past three weeks, you can read all about it, what you can do to adjust to it, and more. Before the diagnosis though, searching for those symptoms would have led you everywhere from the right diagnosis to some rare form of stomach cancer. Similarly, if the doctor prescribes medication, you can read all about it and its side effects as well.

The web's wealth of medical information is really only useful to individuals with health conditions after you've talked to a doctor, but any doctor will tell you that an educated and engaged patient is a good one. Don't hesitate to do your homework, but go in to conversations with your doctor with an open mind. If you're looking for medical information before seeing a doctor, make sure you take what you find with a grain of salt, and if you're really concerned, make an appointment, visit the ER, or use a service that connects you with a doctor right away.

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The New Apple: It Doesn't Just Work

September 26th, 2012Top Story

The New Apple: It Doesn't Just Work

By Brian Barrett

The New Apple: It Doesn't Just WorkSome people willingly overpay for half-baked features in obscure gadgets. These are the early adopters of the world, and they know full well that the things they buy will not work perfectly. Hiccups and glitches are just part of the contract, the accepted trade-off for being first.

Apple's customers are not these people—iPhones are the epitome of a mass-market gadgetry. So why, with two half-baked—and highly touted—flagship features in as many years, has Cupertino suddenly started treating its loyal millions like the world's largest debugging unit?

It Just Works

Apple's best-known mantra might be "Think Different," but anyone who's watched the company through the years will tell you its real clarion call: It Just Works. That's how nearly every Apple product has been described on stage since Steve Jobs returned from NeXT. It may not be Apple's tagline, but it's certainly its biggest selling point.

The remarkable thing is that for the most part, that's been true. Apple's detractors have plenty of sound arguments, but the company could never be accused of shipping products that were unfinished or over-complicated. Babies can use iPads before they can stand. Your grandfather gets FaceTime. People buy Apple because they want to fit in, sure. But also because it's safe.

Click to view That may not sound like much of a compliment, but it is. It's maybe the highest compliment you can pay a consumer electronics company. Just like good design is invisible, good user experience should be functional and intuitive. You shouldn't ever have to doubt it, or even think about it twice.

All of which was true of Apple products until last year. Until Apple decided to make all of its customers inadvertent beta testers.

Beta Siri, Broken Maps

The most ballyhooed feature of the iPhone 4S—remember, there was no new physical design to crow about—was Siri: a "personal assistant" that dominated Apple's advertising all of last fall. It sucked. Its speech recognition could not recognize speech, and its interpretive skills were on par with a competent labradoodle.

The reason for this is simple, and something openly acknowledged on Apple's home page (if not its media buy): Siri was a beta product. Incomplete, by definition. For the first time in recent memory, Apple intentionally pushed a half-baked product out the door. As Mat Honan pointed out last December, the effect was both startling and offputting:

I'm sorry. Beta? Beta is for Google. When Apple does a public beta, it usually keeps it out of the hands of the, you know, public. It typically makes you go get betas. It doesn't force them on you, much less advertise them. Not that it is an effective disclaimer for the vast buying public. For most people who see Apple's ads, and buy iPhones, the word beta means nothing at all. It might be a fish, or a college bro.

Siri could have been easily dismissed as a one-off misadventure; an unfortunate overreach, lesson learned, no harm done. But then Apple Maps happened.

The New Apple: It Doesn't Just Work

The Apple Mapspocalypse has been well-documented, both here and elsewhere, and it's a fresh enough wound that we don't need to belabor it. But if you haven't upgraded to iOS 6—or read a tech story—in the last week or so, it's worth a brief recap. The iPhone and iPad stopped using Google Maps, which were and are terrific, in favor of its own Maps app, which is enough of a horror show that Apple itself has acknowledged the problem (albeit through a thick veil of PRspeak):

We launched this new map service knowing it is a major initiative and that we are just getting started with it. Maps is a cloud-based solution and the more people use it, the better it will get. We... are working hard to make the customer experience even better. Maps is a cloud-based solution and the more people use it, the better it will get.

That's as close to an admission of fault as you're likely to see from Cupertino. And Apple Maps falters for the same reason Siri did; it's a beta product. It's incomplete, in many instances literally so. It's also not going to get better any time soon.

So, Apple released the last two versions of iOS secure in the knowledge that its headline features wouldn't work as advertised or expected out of the box. But why? Why, with so much goodwill built up, with an entire brand built on the principle that it just works, would you knowingly let your most popular product's most prominent feature be subpar?

Actually, the answer's pretty straightforward. And maybe even understandable.

Time Is On My Side

If you haven't chatted with Siri lately—and you wouldn't be alone—you might find yourself pleasantly surprised. She's still not perfect, by any stretch, but she's picked up some handy new features in iOS 6, like making reservations and checking movie times for you. More importantly, though, Siri does the little things demonstrably better than she did a year ago.

She understands what you say better. She returns better search results. Is she perfect, or even very good? No. But Siri has improved the same way all beta programs do: with data and time.

Every time you use Siri, you become a data point for Apple. Siri's success or failure is logged, and used to ensure that future results are more accurate. With a typical program or application, those corrective measures come during the developer preview stage, or from beta testers who get a sneak peek at software and provide feedback. But a knowledge engine like Siri requires hundreds of thousands, even millions of real-world samples to refine its offerings to the point of usability.

The New Apple: It Doesn't Just Work

Combine the tremendous amount of fuel Siri needs to thrive with Apple's notoriously secretive testing methodology, and it suddenly at least makes sense why this particular top-secret iOS feature came out a few sprinkles short of a sundae.

That reasoning holds up with Apple Maps only to the extent that both Siri and Maps are data hogs, requiring years of usage to become whole. Apple's own statement above boils down to: hold tight. But Maps is far more frustrating than Siri because it's entirely an entirely unnecessary—from a user's point of view—backslide.

Apple wasn't forced into a corner; it had full year left in its Google Maps contract, which could have been a full year of perfecting its own product. But the motivation to bring maps in-house—the long-term financial gain of all that localized advertising and user data—was too strong to wait on. And that's Apple's prerogative. It's a public company, which means it owes its shareholders an earnest attempt to gobble up as much money as it can in as many ways as it can. As early users of Google Maps will tell you, though, it takes years and years to get maps right. iPhone users are in for a long road of terrible.

Eventually Apple will collect enough user GPS data and have enough erroneous business listings huffily corrected that its Maps app will, like Siri, become good. Great, even. But out of the box, both are failures. And Apple knew full well that they would be. That they had to be.

Fallout

So this is the new Apple: willing to trade a priori perfection for long-term gain. And this is the new Apple customer: an early adopter of unproven features, a beta tester who likely doesn't know what that term means.

Here's the good news, though; if anyone can scale up a maps effort from whole cloth, it's Apple. The company has a hundred billion dollars of cash on hand. It's aggressively recruiting former Google Maps staffers. And most importantly, it has more than five million iPhone 5s on the market already, and countless iOS 6 iPhone 4S devices sending corrective data back to the mothership.

And who knows? Maybe this ends here. Siri and Maps are highly specialized products with specific needs that can't be met in an isolated testing chamber. They need to be used, and used broadly, to function correctly. There aren't many more bells and whistles that Apple could add to the iPhone that fit that category. If that's the case, then think of these two years as ripping off a band-aid, a necessary discomfort that we'll all forget about by the time iPhone 7 rolls around.

But if this is Apple's new strategy—release, then refine—then the answer is simple. You get to strategize, too. If you have an iPhone 4S now? Wait until Maps gets better to upgrade to iOS 6. The next iPhone comes out with a speculative feature? Don't pre-order. See if it's good now or will be good soon. Wait for reviews. You know, like you do with nearly everything else you buy.

If the only fallout from the Siri and Maps fiascos is that the blind trust Apple has built up over the years erodes a bit, and we start kicking the tires a little more? That's a win for us and for Apple, a dynamic that drives innovation and encourages perfection. It just works.

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When People Use Mobile Devices

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Wednesday, September 26, 2012
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When People Use Mobile Devices
Ad company Kontera tracked data from 15,000 publishers to find out when people are using their PC versus iPhones, Android phones, and tablets, which are lumped as "mobile" in the chart below.

This chart shows for each hour of the day what percentage of total mobile and PC content is consumed. As you can see, mobile usage is strongest from 6 PM to midnight. PC usage is strongest from 11 AM to 5 PM.

What this tells us is that people are using PCs at work, and mobile gadgets at home. Sort of a duh, right? Maybe, but it suggests a big shift in what "personal computing" really means. If we're doing mobile computing largely during our personal time, which is when we're out of work, it means people are more likely to buy tablets than traditional PCs in the future.



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