Everyone here wants to be helpful. When our fellow group members describe a problem they are having or ask for help with a problem, our natural tendency is to want to provide solutions. When someone complains about difficulty with their medical providers or insurance company, our natural tendency is to be on their side and empathize, and share their emotions. These are part of the strengths of this group and other similar groups. It also is the source of potentially serious pitfalls.
The difficulty arises here when these tendencies cause members to overstep the bounds of their knowledge in replying to questions, or ask for answers to questions that no one here should be attempting to answer. It is repeatedly stressed in medical education that the single most important element of medical knowledge is to have a very clear understanding of what you don't know. Any medical professional who keeps that in mind at all times is going to provide excellent care because he will always seek help when he doesn't know something. Any who don't are inevitably going to make major mistakes.
Our role here is to provide other members with information, emotional support, and, at times, to suggest possible diagnostic and treatment alternatives. It is not to diagnose, treat, or pass judgment on their medical care.
How does that apply here?
1. First of all, recognize that with rare exceptions no one here can make a diagnosis from the limited information presented.
2. Recognize that no one here can fully understand anyone else's medical situation from what is presented. It very often is much more complex.
3. Recognize that the information presented may not be accurate, especially in relationship to what someone was or was not told.
4. Recognize that your personal experience does not represent universal truths. Do not assume that someone with similar symptoms has the same diagnosis or that what was appropriate treatment for you is appropriate for someone else.
How does this translate into guidelines?
1. Do not ask for or attempt to provide specific diagnoses. It is reasonable to raise possibilities and provide information. Making a diagnosis requires careful history taking, a physical exam and appropriate testing.
2. Do not ask for or attempt to provide specific treatment recommendations. You may suggest treatments to discuss with their medical team, but do not say you would favor such-and-such. You don't have enough information or knowledge to do so. It's reasonable to relate your experience, but no one should assume one person's experience is right for anyone else.
3. Do not condemn the medical care someone else is receiving. You don't know all the details, you don't know if what has been presented is accurate, and you don't understand the complexities of the case. You may suggest alternatives for others to discuss with their medical team, but do not tell them the care they are receiving is wrong or to seek care elsewhere.
4. It is not the place of anyone here to decide what referrals to specialists others should or should not receive. You can raise possibilities but not make specific recommendations.
5. Stating your own opinion is fine and citing reliable sources of information is always helpful. However, do not cite as fact anything you aren't absolutely sure of. If in doubt, double check. Remember that you may be asked to cite the source of your information, and are obligated to do so if asked.
Some examples:
1. Very commonly someone posts saying they are on a very low carb diet and exercise but still have high sugars. In this situation it is reasonable to suggest they likely need medication. It's reasonable to outline some of the medication options and describe as objectively as possible the pros and cons of each, or to provide links to web sites that describe treatment options. It is not okay to tell them they should take a specific medication. There is far too much you don't know about their medical history, and too much you don't know about prescribing medications.
2. Someone posts saying they have a rash on their abdomen and asking if it is related to their diabetes and what should they do about it. No one should have asked for such a feat of clairvoyance, and no one should have tried to answer this question. It is impossible to diagnose a rash without having training and actually seeing it. Yet I've seen many attempt to answer this and recommend treatment, which could well have made things worse. The only correct answer is to have the rash looked at.
3. Someone posts asking how to treat leg cramps. While this seems simple enough, in fact leg cramps is a tricky diagnostic problem. There are many possible causes, which can be hard to sort out. It requires a careful history, knowledge of the patient's other medical conditions, their medications, a very careful physical exam, some blood tests, and often diagnostic studies. Yet I've seen calcium, magnesium, quinine, massages, etc. recommended with possible disastrous consequences.
4. Someone posts saying they were told their broken nose caused their high blood pressure and diabetes. I've been told more outrageous things than that. Patients often get information mixed up, especially if they've been under stress during the discussion. When someone says something that seems odd or says they were not told critical information, always consider they got it wrong.
When replying to posts, always keep in mind what you do not know in terms of the full medical situation of the poster, the accuracy of information from the poster, and your medical knowledge and ability to understand the complexities of medical situations. We all have the best of intentions but you will best serve your fellow group members by being very careful not to exceed the limits of your knowledge.
Ron
moderator
*** Please always consult with your doctor about what treatment options are best for your situation. ***
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