Today, something a little bit different: keywords and healthcare, but substract the search engine. We’re talking about how healthcare providers use keywords and algorithms, or flow charts, to determine what ails their patients. Two authors point out how using this system on real human beings is fraught with consequences.

New York Times Health column published a review today of two books–“When Doctors Don’t Listen” and “A History of the Present Illness”– written by two nurses and co-workers that address the subject of care providers and how they filter out what their patient’s say during an emergency room visit.

Abigail Zuger, M.D. points out that doctors and nurses tend to listen for keywords when listening to their patients. The keywords are plugged into an algorithm that helps these providers get a pulse on the problem. If you’ve ever neurotically checked webMD to self-diagnose a ‘dog bite’ for rabie,s you’ve probably already played as similar role as ‘doctor’ before.

No, doctors and NPs aren’t using Google to sort out your condition. These are trained professionals, after all. But the flow charts that are used are not totally apolitical. Medicine choice factors into the algorithm, and Zuger hints that how Brand-X ranks over Brand-Y might be influenced by factors other than the patient’s well being.

This is a call-to-action for health care providers, including nurses on the front-lines who most commonly use these ‘decision trees’ to choose personalized care over “a list of variables”.

“And just as world-class chefs eschew standard recipes, so medical experts chafe at formulaic care, pointing out that hard-earned medical instincts should not be ignored, that people usually want to know what they have rather than what they don’t have, and that trainees who rely on algorithms will never learn to think.”NYT

So, I’ll try not to stretch this, but it’s worth noting an analogy to SEO. ‘Black hatters’ beware. Using generic tools to spam the internet in hopes of getting recognized is like a nurse who plugs in the numbers and blames the algorithm if the patient keels over. The only way to provide a valuable service is to get to know the patient , er, um…client. Understanding their background, their personal history, business history, their clientele is the only way to provide a good prognosis and the lasting health of their online presence.