“Dr. Google” and his predecessors

BACKGROUND: Contemporary medicine has expressed concern about lay incursions into the diagnostic process buttressed by commonly available medical information on line. Even while the world wide web is a new structure, there is a long historical precedent for this concern. With the emergence of scientific medicine in the late 19th century came a strong belief in the role of diagnosis, not only to explain disease symptoms but also to differentiate the physician from a range of other unreliable practitioners. Along with this focus on diagnosis came also a concern expressed by doctors about patients' inclination to self-diagnose, or to propose candidate diagnoses for the problems that ailed them. METHODS: This paper uses Zerubavel's social patterning method. Using material written by doctors from the late 19th until the mid-20th century, I explore comments about, and attitudes towards, self-diagnosis. RESULTS: Three areas of concern about self-diagnosis are expressed by doctors. First, self-diagnosis produces anxiety in the patient. Second, it interferes with doctor-patient relationship. Finally self-diagnosis is commonly linked to commercial interests. CONCLUSIONS: Contemporary concerns about self-diagnosis are part of an ongoing social pattern, which simultaneously promotes diagnosis as means for explaining disease but also protests when the diagnostic explanations originate with the patient.