Worried Well on the Web

Eight out of every ten Americans have searched for medical information online. Three-quarters of these searchers do not scrutinize the quality, validity, or date of the information. With the overabundance of healthcare information available on the World Wide Web, people looking for quality medical information could easily be led astray. The unnecessary escalation of health concerns — newly-termed “cyberchondria” — is the focus of a study conducted by Microsoft, and it could have serious implications for many patients.

Approximately 13% of physician visits every year are for medically unexplained symptoms, and up to 25% of patients report such symptoms during physician visits. Often, patients report persistent physical symptoms, but no somatic origin can be found. Physicians may try to explore the psychological basis of the symptoms, but this is a frustrating and futile prospect that uses valuable time and resources with no satisfactory result for the patient.

Many hypochondriacal patients are taking their concerns to the Internet and making “Google” a diagnostic procedure. Researchers at Microsoft recently examined how people search for medical information on the Internet, and reported on its potential implications. The researchers reviewed logs of 515 individual’s health-related Web search experiences. Not surprisingly, one principal finding was that search engines have the potential to escalate medical concerns. The authors assert that the escalation is related to the amount of medical content viewed by searchers, the existence of escalatory terminology in the Web pages, and the searcher’s predisposition to escalate his or her anxiety versus seeking more sensible explanations for physical symptoms.

The Microsoft researchers also found that post-session anxiety lingers after escalations of medical concerns, often to an extent that interrupts other Web-related activities. The information obtained from the Web also influences people’s decisions about visiting a physician, diagnosing or treating ailments, or engaging in proactive health activities. One worrisome finding of the Microsoft study concluded that some users of search engines interpreted the ranking of the Web search results as the likelihood of the illness. The Web can ultimately be a dangerous place for people to seek advice, with no guidance on deciphering fact from fiction, and everything in between.

Not all who seek Web-based information will be misled, but the potential for the wrong information falling into the wrong hands is considerable. Patients should heed a “let the searcher beware” and always obtain sounds medical advice from a trained health care professional. Physicians, however, should be attentive to the needs of patients and maintain open lines of communication when considering all of a patient’s symptoms.


Kappen, T., & van Dulmen, S. (2008). General practitioners’ responses to the initial presentation of medically unexplained symptoms: a quantitative analysis BioPsychoSocial Medicine, 2 (1) DOI: 10.1186/1751-0759-2-22

Wick JY, Zanni GR. Hypochondria: the worried well. Consult Pharm. Mar 2008;23(3):192-194, 196-198, 207-198.

Peters, S., Rogers, A., Salmon, P., Gask, L., Dowrick, C., Towey, M., Clifford, R., & Morriss, R. (2008). What Do Patients Choose to Tell Their Doctors? Qualitative Analysis of Potential Barriers to Reattributing Medically Unexplained Symptoms Journal of General Internal Medicine, 24 (4), 443-449 DOI: 10.1007/s11606-008-0872-x

Salmon, P., Ring, A., Humphris, G., Davies, J., & Dowrick, C. (2009). Primary Care Consultations About Medically Unexplained Symptoms: How Do Patients Indicate What They Want? Journal of General Internal Medicine, 24 (4), 450-456 DOI: 10.1007/s11606-008-0898-0

White RW, Horvitz E. Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search. Redmond, WA: Microsoft Research; November 2008.

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  • If a GP doesn’t have the time to listen (or the skill to figure out what is going on) then people will try to deal with their own experience.

    Presuming that those with symptoms that don’t fit GP’s preconceptions are hypochondriac’s is probably insulting. I think it is the GP’s who have the problem here (and the problem may well be called HMO’s).

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  • Despite the amount of misinformation on the web, I think the internet has done more to help the overall health of society then hurt it. I personally have benefited from doing research on diet, exercise, and other health habits. I agree though – it is very important to double check your information. It is sometimes also really helpful to post on forums to get other people’s perspective who may have been in similar situations. Good article nonetheless and I think the message is really important!

  • I shared this on reddit’s health board by the way!

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  • Rolly

    Often, patients report persistent physical symptoms, but no somatic origin can be found.

    You mean just like patients with MS, Parkinson’s, hypothyroidism, etc… and of course, stomach ulcers, all used to be told it was all psychosomatic, that there was no organic basis to their physical complaints?

    That line of reasoning you just ran is VERY dodgy, and IMHO should be banned from diagnostic reasoning, it leads all too often to false positive psychiatric diagnoses.

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Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.

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