The effect of social media on our lives has been profound. There is no doubt that it can give people a sense of connection and community.
But it can also be a malign force, 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 allow people to perpetuate crazy ideas and absurd remedies.
For doctors, this can be very frustrating. Too often, the people at the centre of the online health debate have no medical training, seem to have only a vague understanding of science, but feel emboldened to speak with authority on highly complex issues that they simply do not understand.
A similar scourge relates to the online promotion of so-called health tourism, or “diagnostic tourism”, in which people travel abroad to undergo tests and procedures, including extensive examinations for various diseases.
Screening tests abroad are often fraught with risk and are much more likely to end up causing completely unnecessary stress.
For example, one social media post that was viewed a whopping 12 million times last week advertised a “30-test full-body health check” offered by a Turkish clinic for £600, claiming to detect heart, eye and even gynaecological conditions. However, these screening tests are often fraught with risks.
While they are presented as a sensible thing for anyone concerned about their health to consider, they are far more likely to end up causing completely unnecessary stress. For a start, the financial cost may not be as much as £600, as often one test will lead to the need to order another, and so on.
But there is also a potentially high physical and psychological cost. Let me be clear: I am not referring to tests that are done to investigate actual symptoms. That is something else entirely.
No, problems arise when examinations and tests are carried out in the hope of “detecting” something that is hidden inside the person and cannot be seen or felt. This is when more problems than the ones already had can be caused.
The truth is that every time you test someone for a disease, you’re performing a delicate balancing act. On one hand, you might find something real and meaningful, but on the other, you might end up subjecting someone to unnecessary and even harmful treatment.
No test is completely accurate, meaning there is always a risk that it will produce a “false positive” which then triggers a series of other, usually more invasive, tests, for example.
Every time someone is tested for a disease, a delicate balancing act is involved.
General examinations carried out on healthy, fit people also often detect other problems that do not actually pose any health risks but which should be investigated with equally risky tests or even operations.
These chance findings are sometimes called “incidentalomas” (benign growths, anatomical variations, etc.), and you’d be surprised how many of us have them. About 20 percent of MRI scans of the brain or spine, for example, detect an incidental anatomical abnormality, the vast majority of which (more than 95 percent) are entirely benign and clinically irrelevant.
A few years ago I had an x-ray of my ankle and by chance they found a strange lump on my foot. I needed a further scan to identify what it was and lo and behold, it was discovered that I had an extra bone in my foot! It was just a strange quirk of nature, which has never caused me any problems and I would never have known about it if I hadn’t had the scan.
However, since it had already been found, I assumed that it would have to be removed. However, when I went to the surgeon, he very cleverly explained to me all the consequences of such an operation, explaining that I would not be able to bear any weight for many months and would probably have to use a wheelchair.
He told me that my legs would deteriorate, so I would need to undergo extensive physical therapy afterwards. The operation itself required general anaesthesia, something that should never be taken lightly, and risked permanently affecting my gait and balance.
There was even the possibility of nerve damage, which could lead to foot drop. It was much safer to forget all about it or enjoy the fact that I was a freak of nature and had more bone in my body than most people. But imagine what would have happened if the surgeon had been unscrupulous.
Or if the abnormality had not been found somewhere easy to examine and assess, like my foot, but in an internal organ, I would almost certainly have had to undergo a biopsy or surgery to see what it was. The same goes for these screening packages, which risk creating unnecessary anxiety, stress and worry.
They incur costs that people may not be able to comfortably afford and risk exposing the person to further tests, procedures and operations, all of which carry risks. Again, I want to be clear: I am not referring to NHS screening for conditions such as breast or bowel cancer, which are very well targeted and rigorously tested for their effectiveness.
No, my problem is with the kind of random screening tests that are considered unethical in this country, but which are increasingly promoted by foreign clinics in the wild west of social media. When you see these flashy ads, always ask yourself: what are the downsides?
A new GP has been suspended for “speeding up” the consultation videos she had to submit as part of her training because they exceeded the 12-minute limit. Some were 45 minutes long. I suspect I’m not the only one reading this and thinking: what lucky patients!
Be careful selling your soles online, Lily
Amidst all the election coverage last week, you may have missed one of the strangest stories to appear in this newspaper. Singer Lily Allen, 39, has joined OnlyFans (a website typically used for sex work and sexual or explicit images) to sell photos and videos of her feet.
Now, part of me thinks, “Good for you, what’s the harm?” If people like this fetish and are willing to pay for these photographs, who am I to judge? But there’s a bigger problem here.
Singer Lily Allen, 39, joined OnlyFans, a website typically used for sex work and sexual or explicit images, to sell photos and videos of her feet.
I have had an alarming number of young patients who have confessed to creating OnlyFans accounts with the aim of making money. They see it as a quick and easy way to manage student debt and offset rising rents.
But they have rarely stopped to consider the long-term implications. After all, these images will be there forever, shared on websites and social media.
With summer seemingly just around the corner, a news story about the effects antidepressants have on our ability to regulate body temperature went viral last week. There is some truth to this: about 10 percent of those taking SSRIs (the most common antidepressants) experience excessive sweating in hot weather.
In addition, sertraline, paroxetine and venlafaxine are known to cause sun intolerance and an increased risk of sunburn in some people. Other medications, not just antidepressants, have the same effects, although doctors do not often discuss them and patients are rarely warned.
Dr. Max prescribes: Time with friends
According to a Harvard study, prolonged loneliness can increase the risk of stroke by as much as 56 percent. Middle-aged people are most at risk. I am often surprised by how much time I spend in my workday on social issues rather than strictly medical ones.
Many of our struggles in life come down to the struggle to find someone to connect with and the best medicine I could prescribe would be a friend.
Long-term loneliness may increase stroke risk by up to 56 percent, Harvard study suggests