The Good and Bad Side of Google (and Other Search Engines)

I conduct a lot of health-related research online. As a book collaborator who specializes in writing for doctors, I find myself on Google so many times a day that I can’t even begin to calculate. This year, my book with Nina Shapiro, MD, came out in which commonly held wisdoms about all sorts of health-related topics, from diet to alternative medicine, are debunked. Aptly titled HYPE: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice — How to Tell What’s Real and What’s Not, the book devotes an entire chapter to the beauty and pitfalls of Google. Below is an excerpt from Dr. Shapiro’s perspective that you might find helpful in your own online searches.

Perhaps more noteworthy than any individual website, newspaper, television show, or magazine is the behemoth Google. This amazing power has become so widespread worldwide that, in 2006, both The Oxford English Dictionary and Merriam-Webster’s Dictionary added “google” as a verb to that year’s print and online editions. And you can google that. Don’t get me wrong: Google is an amazing entity. I use it all the time — all doctors do — and one of its offshoots, Google Scholar (, is a bona fide academic search engine. Google Scholar’s titles are listed both chronologically and by topic. The list order is also determined by the number of citations a given article has received in academic publications. In academic circles, the number of times a given article is cited in other academic articles is one metric to measure its quality, validity, reproducibility, and even popularity.

Google has many strengths, yet some of these strengths, such as rapidity of high-volume information, order of information provided, and how that order is determined, can be quite skewed, especially when it comes to searching medical information. Let’s try googling something commonly searched: “breast cancer treatment.” No surprise that it’s frequently searched given that women have a one-in-eight lifetime risk of getting breast cancer. . . . When I googled this term, it took 0.52 seconds to come up with 110 million sites (the dynamic nature of the internet means you may find a different number of sites). Enough information for you? Should keep you busy while in the doctor’s waiting room. But look a little closer. The top four sites are advertisements (you will load pages different from what I see today, but the gist of this lesson remains the same). That green ad box should be an alert that the site is biased, or at least commercial in nature. This does not necessarily mean that it is bad, inaccurate, or trying to swindle you, but it is what it is — an advertisement. The American Cancer Society’s page doesn’t appear until number five. At the bottom of Google page one are three more ads. Page two is similarly laid out — four ads on the top and three on the bottom of the page. Page three is no different. You get the point. These are what draw the eye in. They are the first sites you see, and the last, giving you one more chance to click on a visually pleasing ad before going to page two. Despite the 109 million plus other sites you have access to, few people will get beyond two pages of a Google search, even though close to half of those sites presented are advertisements. . . .

So how does one possibly assess the validity of this glut of information on such an important issue as breast cancer treatment? Some basics to know are, first, whether the site is an ad. Again, it doesn’t mean it’s wrong, but it does mean it’s biased, by virtue of being paid for by the site to Google if you click on the link. Second, look at those three letters after the dot: .com is commercial; .gov is government funded; .org is a nonprofit organization; .net is internet based, similar to .com; .edu is an educational site, usually tied to a university, private or public. There are a multitude of other codes, but those are the biggies. The number one site on page one of Google for breast cancer treatment is a .com pharmaceutical-company site, advertising a particular drug for metastatic breast cancer. While it also provides information, the first visual you see is the company’s name, the logo, and the name of the drug. . . .

Google is not alone in its interesting search findings. If you study other search engines, they will follow similar formulas. So how can you possibly navigate important issues when there is so much biased information? A few simple tools to remember:

  1. Be aware of the ads. Although many of these have useful information, remember what they are: advertisements. They are selling something—a product, a treatment center, a diagnostic test, or even a nonprofit asking for donations. They may simply be wanting to drive up traffic to their site, but they are paying to do so.
  2. Look for .org or .gov sites first. While many of you might be wary of government-funded sites, they do provide unbiased data from larger studies.
  3. Be wary if a pharmaceutical company is the site provider. Although many drugs are well studied and are lifesaving, hold off on these sites as your first go-to on learning about an illness or a condition.

These tools can apply to any condition, symptom, or health question you may have. Chances are, the less controversial, newsworthy, or even common the condition, the more informational sites over advertisements will appear. When examining and utilizing health websites, keep in mind the many types, including those offering general health information, hospital-based websites, insurance company websites, disease-specific websites, pharmaceutical company websites, noncommercial websites offering drug information, and websites offering information on physician credentials. Given the lack of vetting in the launch and maintenance of a website, you have several tools, and some basic information, to allow you to navigate this entangled web of easily accessible health information.

In general, searching online for health information can be valid, eye-opening, educational, and even useful. . . . But the Web becomes mired when sites angled with opinions, personal anecdotes, blatant exaggeration, and false claims manipulate the navigator to believe what is posted. People also run into trouble when looking for information online based on preconceived notions. If you believe that megadosing on vitamin C will prevent colds, you will seek out (and easily find) sites promoting this notion. If you think that juice cleanses are the way to better health and well-being, it’s easy to find websites supporting this. If delaying vaccines is your cup of tea, online sources abound. . . .

In the deep waters of the internet’s sea of health information, swim carefully. When searching, use terms that do not have an opinion embedded in them. Instead of megadosing vitamin C to prevent colds, start with vitamin C as your search. Learn how this vitamin is absorbed, how it’s metabolized, what a deficiency looks like, what an overdose looks like, and what it looks like to have just the right amount. Always start with the basics. Take time to educate yourself about the nuts and bolts before digging into the extremes or controversies. If you’re concerned about vaccine risks, learn about how vaccines work, what diseases they prevent, and what their benefits are; then you can dive into potential risks and complications. Health information online will only continue to grow.

It was a lot of fun working with Dr. Shapiro to put her book together. The research and stories we synthesized and the lessons we conveyed even changed how I conduct my work online (and approach my personal health). As I helped launch the book campaign with her, I was surprised by how many readers were astonished at the facts we provided and the sheer volume of hype in the world. Indeed, we all need to “swim carefully” in the age of fake news and false advertising. And in a shameless stint of self-promotion — true advertising — I encourage you to check out Dr. Shapiro’s book. It’s not hype.

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