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Medical Help via Internet: The Intelligent Petient's Guide ToThe Internet
by Dr Malpani, MD

 

Take two aspirin and look it up on the Internet - this advice is fast becoming the standard prescription for anyone facing a new or major illness in the West. Medical journals, text books, encyclopedias, research papers, and huge international databases once available only to doctors are now just a mouse click away. Savvy patients can even learn about a breakthrough before their doctor does, and the internet has given birth to a new group of informed, empowered patients who want to make medical decisions in partnership with their doctors, instead of just blindly following the doctor’s advise.

SEARCH ENGINES
ONLINE DOCTORS
CHAT SESSIONS
EMAIL, NEWSGROUPS , LISTSERVS AND MAILING LISTS

While everyone knows that there’s a wealth of medical information on the Net, why are most patients in India still so reluctant to make use of this ? For one, most Indians have become very used to passively following their doctor’s advise. Questions are not encouraged in India – either in the classroom when we are students, or in the doctor’s clinic when we become patients. Also, medical jargon can be intimidating, because it is unfamiliar ( since many words are derived from the classic languages such as Greek and Latin) and is therefore difficult to follow – so must of us would rather not take the trouble of researching our problem independently.

Many intelligent people are also worried that a " little knowledge is a dangerous thing " and are anxious that they may become "half-baked" doctors or hypochondriacs. There is also the worry that knowledge about medical diseases ( and all the nasty complications they can cause ) can result in an increased fear about death and dying - and most people would much rather not come to terms with their own mortality. Many people also prefer to leave everything upto their doctor - after all, that's what you pay him for, isn't it – why confuse yourself with alternatives and options ( the " doctor as a highly paid technician " approach). Another problem is that there are still very few sites about health and medicine in India ( most websites are US in origin) with the result that a lot of the information on the Net is irrelevant to Indians.

So how can you use the internet intelligently to find out more about your medical problem ? Let me start with a warning - it is unwise to try to diagnose yourself – don’t try to play doctor ! If you have a medical problem I strongly recommend that you seek a qualified medical opinion from your own doctor, who can see you, conduct tests if necessary, and diagnose you properly. Once you have a diagnosis, your search for information on the Net can become focussed and productive.

SEARCH ENGINES

Searching for information on the Net is very similar to looking up a book. You turn to the index to look for a particular topic, and on the Net you can use one of the many search engines available, such as hotbot.com, altavista.com, excite.com or infoseek.com. The trouble is that these engines are unintelligent, so that a search usually retrieves thousands of websites– the majority of which are completely irrelevant to your query - and it’s hard to separate the wheat from the chaff. Search engines are most useful when you are looking for information on a rare problem, or very specific information only. Be sure to try several different search engines when looking for information since each one can have different listings included in their data base. You also need to double check your spellings – an error can mean you may not retrieve any useful information at all ! Try to be as precise as possible in order to retrieve relevant information only ( for example, if you are looking for information on eye problems in diabetes, do a search on " diabetic ocular complications".)

It’s easy to get lost in the flood of garbage which a standard search produces, which is why many patients often despair of ever being able to find anything useful or understandable on the Net. In order to make their life easier, experts have put together evaluated subject gateways or medical search engines, to make directed searching for relevant information easier. As their name implies these search services provide the user with a gateway to medical resources on the Internet. However, rather than provide a comprehensive ( but unranked or unsorted ) listing of Internet sites, only those that meet a defined quality threshold are included. The websites are also ranked, according to their quality and usefulness, as determined by these experts. These gateways are produced by medical libraries, doctors and other organizations, and are useful to both new Internet users - who may be unsure where to begin - and experienced surfers who are frustrated with ploughing through the inevitable volume of irrelevant dross when using any of the more general search tools. Examples of such gateways for patients include: www.healthatoz.com,www.medhelp.org, HealthyWay, and Healthcare Resources.

If you are a novice, it can be helpful to have a friendly doctor ( or medical student ) or a librarian to guide you with your first few searches, to teach you how to search efficiently. Cybercafes are a good place to learn how to surf for
newbies ! If you want a comprehensive search of the Internet you must be prepared to search multiple gateways and search engines – the much sought after ‘one-stop information medical source’ has yet to appear. Remember that there’s a lot more on the Net than just tons of textual information on thousands of websites –you can admire anatomy in three dimensions thanks to virtual reality, and even watch video clips of surgery online ! However, mining the Net for information need not be a one-dimensional affair – the real charm of the Net lies in its interactivity , so that you can get a response to your queries !

ONLINE DOCTORS

There are many doctors and health professionals on the internet who will respond to medical questions. The premier site on the web for this service is America's Doctor Online, which offers free real-time one on one chat with a real doctor - but you have to be patient for your turn, as this is a very busy site! These responses are meant to educate the questioner and the public and cannot be a method of rendering personal medical care. Occasionally a response might be directly by email, but most sites use the bulletin board forum and archive all the responses ( what are called FAQs or frequently asked questions) , so that everyone can search, view, and benefit from the information.

CHAT SESSIONS

There are also a few live question and answer chat sessions. If you can't make the scheduled chat time, then at many of the sites you can post your question ahead of time and return later to view the transcripts of the chat and see if your questioned was answered. During the live discussion sessions, you need to ask your question through a moderator and whether or not your question gets answered depends on the number of participants and their questions.

EMAIL, NEWSGROUPS , LISTSERVS AND MAILING LISTS

Newsgroups, which are also called Internet Discussion Groups, function like electronic world wide bulletin boards. In a newsgroup you can post or view messages or reply to someone else's. There are thousands of newsgroups open to the public, and you can use Deja News ( www.dejanews.com) to find the one of interest to you. LISTSERVS, also called mailing lists, are a way of communicating with others via email on various topics of interest. To search for a particular LISTSERV topic go to www.liszt.com. You’ll find there's a support group in cyberspace for just about any medical problem, and instead of being limited to a few local patients, you can communicate with dozens of people going through the same things you are . The Internet also provides a cloak of anonymity, and this is particularly important with illnesses that carry a social stigma, such as infertility or AIDS.

If you have been able to identify an expert on your problem, it is also possible to send him an email directly, and he may then reply to you. You can find email addresses of doctors through a little bit of lateral thinking. Many leading clinics, hospitals and medical colleges have websites which list the names, addresses and emails of their faculty members. Another option is to use an email search engine , such as four11.com. Also, many authors of medical journal articles now include their email addresses along with their institutional address.

Once you’ve found the information, how do you evaluate it ? This is still the most difficult part of searching for medical information, and unfortunately many patients become misinformed thanks to the Net. The problem, of course, is anyone can publish on the net – and it’s not easy to make out whether the information being presented is credible or not ! A good website should be accurate, useful, credible , readable, uptodate and have useful links to other sites - but the most important guideline is to find the source of the information ! Web sites built by well-respected medical institutions and government health agencies such as the US Government’s Healthfinder , Mayo Clinic's Health O@sis , Johns Hopkins' InteliHealth , and Dr. Koop's Community all provide consumer-friendly health information and are reliable sources.

Remember that a lot of the medical information on the Net is designed for the doctor, and this can be quite complex to understand, because it is primarily written for medical professionals. However, this is usually the most reliable, and many leading medical journals now available on the Net , such as the
British Medical Journal, the Lancet, New England Journal of Medicine and the Journal of the American Medical Association, only publish studies after they have been carefully reviewed by leading doctors . Though these may look intimidating, you don’t need a medical degree to read them – each one has a conclusion and a summary that contain most of what you’ll need to know.

It is important to think about how much information you need from the Net to make yourself comfortable with your diagnosis and treatment options. Some people need as much information as they can possibly gather, while others find less information, or information with a specific focus, is best for them.

A warning - do not accept the contents of any single website as definitive. It is in the nature of medical research that many studies contain errors, many conclusions are false, and many reports flawed. This is why you need your doctor’s help to make sense of your information search, because he can best explain to you how the information you have unearthed applies to you as an individual. You need to form a partnership with your doctor - but it should be a partnership of well-informed equals , for which you need to do your homework first ! Remember that the information you retrieve on the Net is simply a tool to help you to get better medical care – it should help to improve the communication between you and your doctor – not replace it !

Ready to start your research on the Net ? Another useful guide is

The Patient's Guide to Healthcare Information on the Internet.

If you would like more detailed information, then look at

The Doctor's Guide to the Internet.



Copyright 1999 Dr. Raj Mehta. All rights reserved.