The patient had already done the research. She arrived with a suspected diagnosis of postural orthostatic tachycardia syndrome, a list of symptoms that fit, and a growing suspicion that something was genuinely wrong with her body. What she got from her physician was a shrug and a suggestion that POTS was, essentially, a moment in the cultural news cycle. The physician declined further workup, citing the absence of syncope, which Naomi Bauer, PT, DPT, is quick to point out is not even part of POTS diagnostic criteria.
This is the case that complicates the dominant narrative around patients and social media. The concern driving most conversations in clinical settings is that patients arrive armed with misinformation, self-diagnoses pulled from TikTok, and a misplaced trust in strangers with ring lights. That concern is real. But Bauer, who practices in physical rehabilitation, says her patient population has shown her another version of the same problem: what happens when a clinician's skepticism about online health content becomes a reason to stop listening to the patient altogether.
"A physician said 'oh, POTS is something that is popular online right now' and then declined further workup," Bauer recounted, describing the encounter that brought the patient eventually to her care. The physician's dismissal rested on a symptom that was never actually required for the diagnosis. The patient was left without answers, and a condition that had a name and a framework went unaddressed.
The reflex to distrust what a patient found online is understandable given the volume of confidently delivered misinformation circulating across health content platforms. But Bauer draws a distinction between skepticism about sources and skepticism about the patient. The approach she has developed centers on listening first. "One thing I have learned is the importance of partnering with the patient to figure things out and taking time to listen and make sure they feel heard," she said. "This then opens the opportunity for discussion and education without making the patient feel they are being dismissed, ignored, or not believed."
That framing repositions the clinical relationship entirely. The question is no longer whether the patient's source was credible, but whether the patient's experience is being taken seriously. From that foundation, Bauer argues, it becomes possible to have an honest conversation about what the evidence actually shows, and where a patient's working theory might need revision. If she were to post about this tension directly, she says she would focus on helping patients prepare for appointments in a way that makes collaboration more likely: "Bringing a clear list of symptoms and experiences, if there are diagnoses that feel they fit then bringing them as requests for the provider's insight and opinion to use both lived experience and medical expertise together to find the diagnosis and treatment."
The algorithm does get to patients first, and that is a genuine challenge for clinical practice. But the POTS patient in Bauer's account was not led astray by social media. She was led astray by a physician who had already decided what her symptoms meant before the workup was done. That is a different problem, and it does not resolve itself simply by discrediting what patients find online.
