That question confronts every American who visits the website CrowdMed.
Launched in April 2013, CrowdMed attempts to help patients find solutions to perplexing medical problems by gathering insights from a large online community of “Medical Detectives” composed of doctors, healthcare professionals, and other people with specialized knowledge.
CrowdMed CEO Jared Heyman says his organization fills a void in the current medical system.
“The medical system seems to really fail when it comes to helping patients that have very complex, unsolved medical cases,” Heyman said in an interview with WND.
Patients begin the process by anonymously submitting a questionnaire detailing their symptoms, health history, and any relevant diagnostic images or test results. CrowdMed encourages patients to offer compensation to incentivize the people who help solve their cases.
Once a patient’s case is posted, Medical Detectives are free to view it. These Medical Detectives may discuss the patient’s case with them and offer suggestions. The site attempts to filter out bad suggestions by prioritizing those that include solid research, references, and the support of other experts.
At the end of the process, patients receive a report that includes the top diagnostic suggestions from the community, along with references and explanations. When the patient selects what he or she deems the best answer and closes the case, any compensation offered is awarded to the Medical Detectives who contributed the most to that answer. The patient and his or her real-life doctor may then use the report to help determine a treatment.
Heyman said the average CrowdMed patient has been sick for eight years, seen eight doctors, and racked up over $60,000 in medical bills before coming to the site. But once a patient submits a case, the Medical Detective community typically solves it within weeks, at a cost of roughly $200.
Heyman sees this as a free market triumph over medical bureaucracy.
“The established medical system needs a site like us to be an adjunct to it, and we’re trying to provide something that’s missing,” he said. “It’s a well-known fact that bureaucracies just don’t do a good job of innovating on their own, so we’re trying to provide the innovation that probably would not come from within the medical system.”
That innovation is built on crowdsourcing, which Merriam-Webster defines as “the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people, and especially from the online community, rather than from traditional employees or suppliers.”
Heyman said he has spent years studying the wisdom of crowds and is convinced that many heads are better than one.
“A crowd’s collective knowledge is virtually unlimited, but a single individual’s knowledge is very limited,” Heyman said. “So we use crowds to overcome that human limitation and give patients a much better chance of having someone out there who can tell them what’s wrong.”
Heyman expressed pride in his site’s track record thus far. He said he has over 15,000 Medical Detectives currently registered on the site, about 2,000 of whom have logged on in the past 90 days. These detectives have resolved almost 700 cases. He said 60 percent of patients whose cases were resolved came back and told CrowdMed that the site had brought them closer to a correct diagnosis or cure.
The CEO also said his site aims to give more power to patients. He said sites like WebMD and Google took the first step by allowing patients to research their own medical conditions without relying on a medical professional. But he believes CrowdMed improves on that model by giving patients access to medical professionals, not just information, online.
“Yes, patients have access to the Internet, but now they have access to online crowds as well, which furthers that patient empowerment trend,” Heyman said.
Lee Hieb, M.D., author of “Surviving the Medical Meltdown: Your Guide to Living Throught the Disaster of Obamcare,” recently signed up to be a Medical Detective on CrowdMed. She said she likes the idea behind the website.
“I’ve always said there should be a journal of good ideas, and this is essentially a variant on that idea – that you don’t have to prove what you’re saying, you just have to tell them your opinion, and you might be the smartest guy in the world at this point,” said Hieb, an orthopedic surgeon.
She stressed that the medical field itself, like CrowdMed, is all about discussion and debate among doctors.
“Every time you go to a doctor, all you’re getting is an opinion,” she said. “And that opinion is based on what he considers the valid evidence. But that’s the big kicker – what is valid evidence? So everything is opinion, and it’s scientific opinion.”
However, Hieb raised a couple of concerns about the site. She wondered what would happen if a patient liked the final suggestion from the crowd, but couldn’t find a doctor who agreed with the advice and was willing to implement it.
There’s nothing CrowdMed could do to help a patient in that situation, according to Heyman. Patients must be their own advocates.
“We can give patients a nice PDF report that says, ‘Here’s probably what you have, and here’s why,’ but it is ultimately up to our patients to be the CEO of their own health and push for their doctors to consider all options,” Heyman said.
Hieb also worried about the ever-present threat of medical malpractice suits.
“Part of me says this is a great idea and it sounds really good, because the more brains the better, but how do you avoid the liability issue?” she asked.
In fact, the CrowdMed website states that Medical Detectives are not legally liable if their suggestions are incorrect, because their activity is anonymous and patients are to understand that suggestions are merely recommendations, not definitive diagnoses or treatment plans. The site emphasizes that only the patient’s doctor can ultimately determine the correct treatment.
Heyman insisted he is merely trying to help patients and their doctors, not supplant the current medical system.
“We think doctors will always be necessary to confirm a diagnosis and to prescribe the appropriate treatment to a patient,” Heyman said. “Our job is to provide a shortlist of insightful diagnostic and solution suggestions or ideas that the patient and their physician have probably not yet considered.”
Hieb agrees that CrowdMed can never replace a real, in-person doctor. She advises interested patients to treat the site as a supplement to actual medical care.
“I think medicine is still between a doctor and a patient in an office,” she said. “Don’t devalue the benefit of hands-on touching and knowing your patient… This is kind of a niche thing. It’s not going to be the nuts and bolts of the practice of medicine, but it certainly will add to it.”