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The internet is not your doctor: When self-diagnosis goes wrong

New research shows that as an expat, you are likely to consult the internet with your health symptoms. But the risks involved can be significant. Here’s why you need to stop typing and step away from your computer.

The internet is not your doctor: When self-diagnosis goes wrong
Researching your symptoms online can lead to health anxiety and incorrect diagnoses. Photo: Getty Images

We’ve all done it. That strangely swollen toe, tingle in the throat or persistent headache. Simply type your symptoms into the online search bar and watch as the diagnoses appear. With the click of a button, innocent symptoms evolve into life-threatening illnesses, or maybe your scary medical dilemmas dissolve away, reassured by the information on your screen. 

In partnership with AXA – Global Healthcare, The Local looks at the risk and rise of the online self-diagnosis.

When your own research goes wrong

A quick look at Reddit uncovers hundreds of tales from medical professionals sharing the mishaps, and the occasional success, of online self-diagnosis. 

One father made a scene at a hospital demanding his daughter have an MRI, only to discover the ‘rash’ she had was a very non-life-threatening ink transfer, probably from her clothing. There was also a woman who searched her health symptoms online and discovered she was in labour (actually!), a man who had convinced himself he had gestational diabetes – a condition exclusive to pregnant women. And then there are the many tales of panicked people visiting their doctor, scared and anxious that they have cancer after doing some online research.

But for all the funny stories and relatable anecdotes, there are of course problems and real risks with diagnosing yourself from information online. 

Avoid a self-diagnosis mishap with a virtual doctor service

Help me, internet 

While the act of online self-diagnosis is not new, the role of online health information and the importance of virtual healthcare grew during the Covid-19 pandemic. People were encouraged to check their Covid symptoms at home, accessing all the information they needed via health authorities online. 

At the same time, the uncertainty around the virus and instructions to stay at home meant many people were unable to access health care, or avoided seeking it in-person. Why take a risk when you can open your laptop and search? 

The problem with this is threefold. You will either self-treat your self-diagnosis (which can be dangerous and do more harm than good). Or, think you are okay, when in fact, you need medical help. Option three involves overreacting to a condition that is not as bad as you thought, causing worry and stress. This can even lead to ‘cyberchondria’, which is when the internet searching of medical information and its associated worries about health becomes excessive. 

Reliable online help is out there. AXA’s global health plans will allow expats to speak to doctors in a range of languages via their Virtual Doctor Service

Virtual healthcare services are convenient but don’t have the risks of online symptom searching.

Mind health matters for expats

For those of us living abroad, the online self-diagnosis phenomenon is even more common. Jumping online is easier than navigating a foreign medical system, right? 

AXA – Global Healthcare recently conducted its biggest ever piece of research on mind health issues, in the wake of Covid-19. The findings can be read in their Mind Health Index

One of the most shocking findings of the research was that almost a third (28 percent) of mental health conditions among people living internationally had been self-diagnosed. 

The study surveyed 11,000 people from 11 countries and territories in Europe and Asia, with 13.5 percent of those participating being individuals who live abroad. The research acknowledged the unique set of mental health challenges faced by expats, who are away from support networks and the comforts of home. 

Depression and anxiety were the most common issues self-diagnosed by internet research among the non-natives surveyed. Worryingly, only 26 percent of internationals who self-diagnosed said their condition was being managed ‘well’ or ‘very well’. This is compared to 49 percent of those with a properly diagnosed condition. Quite clearly this shows the importance of talking to a medical professional about your mental health. 

AXA provides mental health and wellbeing healthcare as part of its global health plans

Overcome the barriers to seeking proper care

Navigating a foreign medical system can be daunting and off-putting, especially when you’re not feeling your best. Not knowing who to call or where to go is only going to exacerbate certain conditions, like anxiety, especially if you don’t yet speak the local language. 

So not understanding the medical landscape of where you live is an obvious reason to turn to online self diagnosing instead. Only around half (53 percent) of expats in AXA – Global Healthcare’s Mind Health Index said they knew how to access mental health help if they needed it. 

“It’s worrying that so many non-natives are using the internet to self-diagnose, but perhaps not surprising,” said Rebecca Freer, Head of Marketing at AXA – Global Healthcare. “Knowing how a local healthcare system works can be challenging, let alone knowing the sources of support you can trust. In contrast to these potential barriers to seeking help, the internet can seem to offer fast and credible sources of advice.”

While accessing healthcare can be one of the challenges of living overseas, overall the experience of life abroad should, and can, be a positive one. Though it’s increasingly common to research your symptoms online, don’t let the risks of a misdiagnosis or an unnecessary spiral of worry and fear impact you. Think again before consulting the internet with your health symptoms.

Get a quote for an insurance plan that suits you from AXA – Global Healthcare and access quality healthcare from their trusted networks

Virtual Doctor service provided by Teladoc Health
Mind Health service provided by Teladoc Health
AXA Global Healthcare (EU) Limited. Registered in Ireland number 630468. Registered Office: Wolfe Tone House, Wolfe Tone Street, Dublin 1. AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland.
AXA Global Healthcare (UK) Limited. Registered in England (No. 03039521). Registered Office: 20 Gracechurch Street, London, EC3V 0BG, United Kingdom. AXA Global Healthcare (UK) Limited is authorised and regulated in the UK by the Financial Conduct Authority.

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HEALTH

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 

No. 

What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone. 

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