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The explosion of internet accessibility opened doors to endless opportunities for learning and discovery. A leading example is the wealth of medical information provided by clinicians to help patients better understand their symptoms and health conditions. However, what began as an effort to improve healthcare literacy grew into what we now know as “Dr. Google”—a search-engine-based framework fueling self-diagnosis.
According to a recent survey of 2,000 Americans, 65 percent of healthcare consumers use the internet to diagnose their symptoms (OnePoll, 2019). Among that population, 74 percent felt more anxious about their health after self-diagnosing and 43 percent falsely believed they had a serious disease (OnePoll, 2019). What’s more, 6 out of 10 respondents said they were actively avoiding their doctor to discuss these concerns (OnePoll, 2019).
These alarming statistics bring to light a fundamental shift in patient attitudes and behaviors toward the healthcare system. Steering clear of the doctor’s office or following treatment recommendations based on misinformation only allows symptoms to grow worse, at which point the cost of care skyrockets and positive outcomes become difficult to achieve.
Self-diagnosis in the MSK space
In 2015 alone, over 124 million American adults were self-diagnosed with one or more musculoskeletal (MSK) conditions (Edwards, 2016). A critical flaw of online symptom checkers is the lack of personalization and, by extension, accuracy. One systematic review found that the highest primary diagnostic accuracy rate among online symptom checkers was only 38 percent (Wallace, 2022). This lack of clarity is detrimental to MSK patients, who often face chronic, life-altering pain requiring a clear diagnosis and personalized care.
Once diagnosed, those who choose to seek care often look to the wrong clinician. For many, this is a primary care physician (PCP) who is often lacking comprehensive training to properly treat MSK conditions. These physicians often serve as the entry point to a costly cycle of inappropriate referral to orthopedic or spine surgeons, resulting in large volumes of unnecessary imaging, procedures, and surgeries.
A recent claims analysis from the Blue Cross Blue Shield Association found that, from 2010 to 2017, joint replacement surgeries increased dramatically, with 17 percent more knee replacements and 33 percent more hip replacements (BCBSA, 2019). These elective procedures totaled $25 billion in 2017—a 44 percent increase in orthopedic spend from 2010 (BCBSA, 2019). As the volumes of joint replacement surgeries rise, so does the evidence that they are not always appropriately recommended. One study found that over 34 percent of these procedures are indeed inappropriate—an alarming figure tied directly to the large-scale increase in surgery utilization (Riddle, 2014). This data point also clearly signals the lack of adequate non-operative interventions recommended to patients in the traditional care setting.
While the self-diagnosed patient journey may also include a physical therapist (for 34 percent of patients) or chiropractors (for 53 percent of patients), these isolated care modalities simply aren’t enough (McCarthy, 2018). What’s needed in the MSK space is a multidisciplinary approach that treats MSK conditions from more than just the physical angle. This requires oversight by the kind of physician who understands how to correctly diagnose and comprehensively address the complexities of each condition.
Identifying the right physician and care team
If patients can immediately connect with a MSK physician trained in appropriate non-operative care, the chances of better outcomes at a lower cost significantly increase. One study found that patients with new-onset low back pain (LBP) who were evaluated by a physician and appropriately referred to early physical therapy generated 60 percent less LBP-related costs, as rapid intervention with appropriate care reduced the need for imaging scans, injections, opioid pain prescriptions, and surgery (Childs, 2015). With the right physician at the helm, holistic MSK care teams can provide the most appropriate treatment up front, pick up on any red flags (clinical symptoms or findings worrisome for a serious medical condition) that require further testing, and escalate or de-escalate care as needed.
Vori Health’s approach to MSK care is laser-focused on finding the right diagnosis as early as possible, followed by highly specialized root-cause treatment. Vori Health’s non-operative MSK physicians and multidisciplinary care team—which also includes a physical therapist, registered dietitian, and certified health coach—address each aspect of a patient’s health condition. From the start, each patient connects with a doctor-led team that works collaboratively to relieve symptoms and promote whole-person health while minimizing costly and unnecessary treatment.
Learn more about how your members can access Vori Health’s doctor-led teams to get the right care up front and mitigate the costs of MSK self-diagnosis.
REFERENCES
• OnePoll, 2019: OnePoll and LetsGetChecked. (October 2019). Where are Americans turning to for answers about their health?
• Edwards, 2016: Edward BJ and Watkins-Castillo SI. Self-Reported Musculoskeletal Conditions. United States Bone and Joint Initiative, accessed June 7, 2023
• Wallace, 2022: Wallace W, Chan C, Chidambaram S, et al. The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review. NPJ Digit Med. 2022;5(1):118.
• BCBSA, 2019: Planned Knee and Hip Replacement Surgeries Are on the Rise in the U.S. (2019, January 23). Blue Cross Blue Shield Association
• Riddle, 2014: Riddle DL, Jiranek WA, Hayes CW. Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. Arthritis Rheumatol. 2014;66(8):2134-2143.
• McCarthy, 2018: McCarthy J. (2018, October 3). Medical Doctors, Chiropractors Top Choices for Spine Care. Gallup
• Childs, 2015: Childs JD, Fritz JM, Wu SS, et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015;15(150).
