On the internet, you see advice thrown around all the time, and as a clinican, usually when what I do comes up in the conversation, it’s not uncommon for people to ask me “simple” questions about their health, and what things they can try to help with their “simple” problem.
My response of “hmm…” and “I really can’t give an answer without a consult” is not really the answer they’re hoping for. After all, there’s advice being flung about all over the internet and (offline) so why am I hedging? Am I just trying to weasel out a consult?
The short answer is no. If you want the longer answer… then here it is.
The real reason why I (and other naturopaths) really can’t give answers to “simple questions” asked in social situations or via text, comment, or message (private or public) is because of something called Duty of Care which means that legally, I have to make sure that the information I give to people doesn’t harm them. In order to find out that my “simple” advice to your “simple” problem is actually the right kind of advice, I have to ask so many more questions.
“But my question really is just a simple question…” you might be thinking. Well here are some examples of when it wasn’t just a simple question.
“What is good for cramps?”
How many people right now want to jump in and give advice? Anyone? Rather than giving this person the sort of advice you might hear be bandied about, I recommended this particular person go to the doctor, or to the hospital before I could talk with them.
If you’re wondering why that is, it’s because I received this message at a very unusual hour. Which made me think that the person asking it was in serious discomfort to contact me at such an hour. And even if I hadn’t had that tiny little red flag to go on, these are just some of the things I want to know before I’d give any advice to a “simple” question like this:
- What kind of bloating is it? Is it associated with the menstrual cycle? If so- is it mid-cycle or during menstruation? Is there spotting associated? Or if not, is it associated with digestion? And bowel movements?
- How painful are we talking?
- Is it located to one side?
- Has the person had a temperature?
- How long have they had the pain for?
- What medications have they taken for the pain? (what medications are they taking generally? & over the counter products?)
This is only the tip of the ice-berg of the questions I’d want to ask.
Without being able to ask more information and seeing the person, you can’t give this person any advice. It could be anything from appendicitis to ovarian cysts and many many other conditions and as it turns out it was something serious, and it was good that I’d recommended what I did.
As a naturopath I’m not a diagnostician (like House from the popular TV show, or even your local GP), but I am trained to see red flags which tell me when a situation is more than a “simple question” and when they need to see a doctor ASAP.
A lot of the people willing to give health advice on such little information as we had above are either completely untrained in pathophysiology (and there are courses out there in the health sphere that do release graduates who don’t have an understanding of these issues) or they are well meaning people with no formal education in health unaware of the potential serious conditions these innocent questions can indicate or… worst case scenario they could be genuinely trying to help but see an opportunity to make a dollar (eg. multi-level-marketing consultants often give nutritional advice and promote sales of their products without having any formal training in nutriton at all).
So as it turned out…fortunately for this person, I recommended a visit to the hospital and they found out there was a serious medical reason for the pain. But how many other people would have jumped in with the usual kinds of online recommendations you get nowadays? eg. green smoothie? probiotics? ….coconut oil? turmeric?
How about another one: “What’s good for anxiety and stress?”
Hmm…. ok…. I’ve been asked this one so many times that if I had a birthday for everytime it was aked I’d be ancient. Rather than rushing in with some of the more common suggestions you’ll see, some of the many questions I’d want to ask are:
- Are you drinking coffee? if so how much?
- How much sleep are you getting?
- What is your diet like? Are there any food intolerances?
- Are you on medications?
- How old are you? What gender?
- What medications are you taking?
This is just the tip of the ice berg on this one.
But you know the advice I see given most often? Go gluten free or increase the protein.
While this advice may or may not be valid, there are soooooo many other things which could be contributing to the problem and you can’t assess that without a far more detailed conversation.
How about another… “Oh you work in fertility? Got any tips to help us conceive? We’ve been trying for a while.”
- How long is awhile?
- When during your cycle are you trying?
- What is your cycle like?
- How old are you both?
- What is your diet like?
- what medications are you taking?
- Are there any health conditions or issues in your health history which could impact on your fertility?
I don’t expect the person to know which conditions can have an impact on their fertility, its why I take 90 minutes in my initial consult because I have a whole list of things I ask in this situation and generally him and her when it comes to fertility.
And if you want one more… “My child has stomach aches and cries a lot. What should I do?”
You can guess what my advice is when I see this one in a forum…Thats right – see the doctor! Babies and toddlers cry for many reasons.
- How old is the child?
- Do they have blood in their poo?
- How often is “a lot”?
- Are they sick?
- Are they eating/ drinking?(and if so what / how much…)
and so so so many more questions I’d want to ask (and if its a child my first question is usually “Have they seen the doctor?” and if the answer is no then my only advice is to go to the doctor first. It’s because there are literally SO MANY THINGS that can be going on with kids some that I have some great options for and some that I dont and I’m not going to take that chance with someone’s child.
The sad thing is my rational response is usually the only comment on the page that gets no “likes” or “thank yous”. I wont tell you some of the ridiculous things which get recommended and do get the likes and thank yous, because I’d hate for someone to scroll through this post because they’re too busy to read it and just see that and mistakenly think that was something I was suggesting! Which really leads to another problem I see out there… but that’s an issue for another post.
So I hope you can begin to understand why “simple questions” aren’t really simple. Were you ever given the “hmmm” response to what you thought was a simple question? Or do you see a lot of “simple questions” being asked where you hang out? What do you think about that now?