Tech + Health

08.15.14

Strangers Diagnose Your Illness and Get Cash in Return

The website CrowdMed lets you outsource your medical diagnoses to users competing for points and cash. Is it the solution to online hypochondria, or part of the problem?

The Internet has only a few unspoken rules, but they’re best followed closely: Don’t post lewd photos with your face showing. Think twice before tweeting a bawdy joke. And no matter how strong your constitution, never seek medical advice online.

The third rule reads like a platitude, but it’s remarkably true. The Internet has a tendency to magnify even the most mundane bumps and bruises, transforming toothaches into oral cancer and fleeting cramps into tetanus. Online diagnoses are delivered hyperbolically and without a shred of bedside manner.

But it’s a perception that can be dismantled and reframed, according to CrowdMed, a San Francisco-based website that seeks to defeat misinformation by crowdsourcing diagnoses. Founded last year and steadily recruiting users, the site pairs patients with “medical detectives,” problem solvers who might be doctors, nurses, or strangers sharing your same symptoms.

“The reason the Internet has not been good for giving medical answers is [because] the information is very unfiltered,” said Jared Heyman, the founder and CEO of CrowdMed. “No one had yet solved the technical challenge of how to separate signal from noise.”

CrowdMed aims to do just that—cut through the nonsense that proliferates on places like Yahoo Answers and deliver reliable guidance. The key to outclassing existing platforms, Heyman said, are cash rewards for accurate diagnoses, and patented “predication market technology.” The latter is, in short, an algorithm.

“[Medical detectives] get points for what is believed to be the best answer,” Heyman explained. Detectives are then ranked by past performance and peer reviews, gaining or losing influence with each case. “So the end results… aren’t based on one person’s opinion. They’re based on the consensus of dozens of people, sometimes hundreds of people, collectively deciding between the different possibilities.”

CrowdMed is a system that caters to patients with physical and mental illnesses that are chronic in nature, Heyman said. The average CrowdMed patient has been sick for six years, seen eight doctors, and incurred more than $50,000 in medical expenses, according to the website. And since 2013, the site has helped users to diagnose cases of leaky gut and Lyme disease, iron deficiency and iliac vein compression, Heyman added.

“It’s not always the person with the [highest] number of degrees or most years of experience who’s the best case solver.”

CrowdMed is also a system where Ivy League diplomas and prestigious residencies carry no clout. “We don’t care what your formal credentials are; what we care about is performance and peer ratings,” Heyman said. “It’s not always the person with the [highest] number of degrees or most years of experience who’s the best case solver.”

CrowdMed’s leaderboard spotlights the most astute detectives—and currently, “some of our best case solvers are not even doctors,” Heyman said.

In waging war against faulty online diagnoses, CrowdMed’s adversaries aren’t just trolls. They’re also wrestling with human psychology.

“There’s something about looking for answers online where the default is a worst-case scenario rather than a best-case scenario,” explained Dr. Sean Akerman, a guest faculty member at the Sarah Lawrence College Psychology Department. And oftentimes, we can project hypochondria onto others, Akerman said.

“Your hypochondria doesn’t just stop with yourself,” he said. “It spreads to other people, too. It also plays out with forecasting the worst for other people.” As a result, Akerman said CrowdMed may appeal to the more neurotic of us who wish to be “armchair physicians.”

Dr. Rachel Annunziato is an assistant professor for clinical psychology at Fordham University—and at present, she believes the perils of online diagnoses outweigh the perks. “Probably right now, there are more concerns than benefits,” she said. “It’s certainly quicker, and it may in some cases get someone urgent care who was hesitating. On the other hand, you potentially risk misdiagnosis, or alleviating concerns when you should have concerns.”

But CrowdMed also offers hope for the disenfranchised, Annunziato said, like rural populations far from care, or poor without access to a physician. “My mind does wander to some situations where potentially there is a benefit, especially for those who aren’t getting any [health care] at all.”

Annunziato and Akerman are in agreement that CrowdMed is best deployed as a supplement, not a substitute. “So much of medicine is based on seeing and feeling, and that element is completely lost with online communities,” Akerman said.

Heyman agrees.

“We tell all of our patients that CrowdMed is not a definitive diagnosis and treatment plan,” he said. “It’s our job to provide a shortlist of diagnostic suggestions. We’re not planning on changing that.”