The effect of social media on our lives is enormous. It can undoubtedly give people a sense of connection and community.
But it can also be a force for evil, spreading misinformation and fear, and allowing the darker sides of human nature to fester and grow.
This is especially true when it comes to health. Yes, sites like Facebook, Reddit, and Instagram can educate people, but they can also enable people to continue to spread crazy ideas and foolish remedies.
For doctors, it can be incredibly frustrating. All too often, the people at the centre of online health debate are not medically qualified, seem to have only a vague grasp of science, yet feel empowered to speak with authority on very complex issues that they simply do not understand.
A similar plague is occurring in the online promotion of so-called health tourism, or “diagnostic tourism,” in which people travel abroad for tests and procedures, including comprehensive screenings for various conditions.
Screening tests abroad are often risky and much more likely to cause unnecessary stress
For example, a social media post viewed 12 million times last week advertised a Turkish clinic’s £600 ‘30-test full body MOT’, which claimed to be able to detect heart, eye and even gynaecological conditions. Yet these screening tests are often risky.
Presented as something sensible for any health conscious person to consider, they are far more likely to end up causing completely unnecessary stress. For starters, the financial cost is unlikely to top out at £600, as one test often leads to another having to be ordered, and so on.
But there are also potentially high physical and psychological costs. Let me be clear: I am not talking about tests that are done to investigate actual symptoms. That is something completely different.
No, the problems arise when scans and tests are performed in the hope of ‘catching’ something invisible and unfelt. Then you can actually cause more problems than you ever had.
The truth is that every time you screen someone for a condition, you are performing a delicate balancing act. On the one hand, you could find something real and important, but on the other hand, you could be putting someone through unnecessary and even harmful treatments.
No test is 100% reliable. There is always a risk that the test will produce a ‘false positive’ result, which will then lead to a series of other, often more invasive tests.
Every time you screen someone for a condition, you perform a delicate balancing act
During general screening of otherwise healthy and fit people, incidental issues are also regularly discovered that do not in themselves pose a risk to their health, but which then have to be investigated with equally riskier tests or even operations.
These chance findings are sometimes called “incidentalomas”—benign growths, anatomical variations, and so on—and you’d be surprised how many of us have them. About 20 percent of MRI scans of the brain or spine, for example, find an incidental anatomical abnormality, the vast majority of which (more than 95 percent) are completely benign and clinically irrelevant.
A few years ago I had an x-ray of my ankle and, by pure chance, they found a strange lump in my foot. I had to have another scan to identify what it was, and lo and behold, it was discovered that I have an extra bone in my foot! It was just a strange quirk of nature that has never caused me any problems, and I would never have known if I hadn’t had the scan done.
However, because it was found, I assumed it would have to be removed. However, when I saw a surgeon, he very astutely went through all the implications of such an operation, explaining that I would not be able to bear any weight at all for months and would probably have to use a wheelchair.
My legs would become deconditioned, he said, so I would need extensive physical therapy afterward. The surgery itself required general anesthesia, which should never be taken lightly, and there was a risk that my gait and balance would be permanently impaired.
There was even a possibility of nerve damage, which could result in a drop foot. It was much safer to forget it all – or to enjoy the fact that I was a freak of nature and had more bone in my body than most people. But imagine if the surgeon had been unscrupulous.
Or if the abnormality had not been found in an easily examined and assessed location, such as my foot, but on an internal organ. Then I would almost certainly have had to undergo a biopsy or surgery to see what it was. The same goes for these screening packages. They run the risk of creating unnecessary fear, stress and worry.
They create costs that people may not be able to comfortably afford and risk exposing the person to more tests, procedures and operations, all of which carry risks. Again, let me be clear: I am not talking about NHS screening for conditions such as breast or bowel cancer, which are narrowly targeted and rigorously tested for effectiveness.
No, my problem is with the kind of random screening tests that are considered downright unethical in this country, but are increasingly being pushed and promoted in the wild west of social media by clinics abroad. Always ask yourself when you see these glossy ads: what are the downsides?
A new GP has been suspended after she ‘speeded up’ videos of consultations she was required to submit as part of her training because they were longer than the 12-minute time limit. Some were 45 minutes. I suspect I’m not the only one reading this and thinking: lucky people!
Be careful selling your soles online, Lily
Amidst all the election coverage last week, you may have missed one of the most bizarre stories to appear in this newspaper. Singer Lily Allen, 39, has joined OnlyFans – a website generally used for sex work and sexual or explicit images – to sell photos and videos of her feet.
Now I think to myself, good for you, what’s the harm? If people are into this fetish and are willing to pay money for these pictures, who am I to judge? But there’s a bigger issue here.
Singer Lily Allen, 39, has joined OnlyFans – a website generally used for sex work and sexual or explicit images – to sell photos and videos of her feet
I’ve had an alarming number of young patients admit to creating OnlyFans accounts to make money, seen as a quick and easy way to manage student loans and offset rising rents.
But they have rarely considered the long-term implications. After all, these images will live forever, shared on websites and social media.
With summer seemingly just around the corner, a story went viral last week about antidepressants affecting our ability to regulate our body temperature. There’s some truth to that. About 10 percent of people taking SSRIs – the most common antidepressant – experience excessive sweating in the heat.
And sertraline, paroxetine and venlafaxine are known to make some people sun intolerant and more likely to get sunburn. A number of other medications, not just antidepressants, have similar effects – although they are often not discussed by doctors and patients are rarely warned
Dr. Max prescribes: Time with friends
Long-term loneliness can increase the risk of stroke by 56 percent, according to a Harvard study. Middle age is at greatest risk. I am often struck by how much of my workday is focused on social issues rather than strictly medical ones.
So many of our problems in life stem from the struggle to find someone we can connect with. The best medicine I could ever prescribe is a friend.
Long-term loneliness can increase the risk of stroke by 56 percent, Harvard study finds