Wednesday, March 03, 2010

How the internet can promote ethical medical practise


Many good doctors are wary of putting up their own website. They feel that this will be seen to be advertising their practise - something which is unethical and demeaning to their dignity. Doctors are professionals and advertising to solicit patients is unethical and frowned upon . It is also true that many quacks have put up websites which are full of garbage and tall claims , as a result of which many responsible doctors have shunned the internet so far.

However, it is my argument that it is unethical in this day and age for a doctor not to have a website !

The word doctor is derived from the word, "docere", which means to teach. An integral part of a doctor's responsibility, both to his patients and to society, is to teach patients about their medical problems and help them to remain healthy . A website is one of the best tools to do so . It is quite inexpensive to publish a website and as internet penetration and smartphones become ubiquitous , it will be possible to reach practicalyl everyone through the web. Websites are accessible 24/7; can be easily updated; and the information can be provided in various languages , using rich audiovisual media formats. Doctors who do not share their hard-earned wisdom using the web are actually doing a disservice to their patients by being selfish and hoarding their knowledge!

Websites promotes transparency because everything is written down. They promote empathy, as doctors learn to be patient-centric and to provide information in language which patients can understand. It helps doctors to remain uptodate, as they need to publish current information; and helps to improve the doctor patient relationship because doctors need to polish their communication skills when writing articles for their website. Websites facilitate direct doctor - patient contact, and cutting out the middleman will also enhance the doctor patient relationship.

One of the reasons many patients get poor medical care is because of misleading articles in the media which often hype the "latest medical advance" without providing any context or information about the problems and limitations associated with these so called advances. A good example is the use of stem cells to cure everything from Parkinson's disease to Alzheimer's. Responsible doctors can use their websites to educate patients and explain the ground reality , so that patients do not get taken for a ride by unethical doctors.

It is true that there is a lot of rubbish on the internet. Good doctors can provide reliable trustworthy information on their sites which can serve as a powerful antidote to this problem - information which can help to dispel myths and misconceptions. Information therapy is powerful medicine and doctors need to learn to prescribe and dispense this !

If doctors take the time and trouble to educate their patients using the internet, patients will become empowered. Expert patients can form online patient communities, to guide other patients ; inform and educate them; and provide them with emotional support. They will provide first hand accounts of what the treatment entails - and will also be able to identify good doctors and bad doctors.

I think the formation of online patient communities will make a big difference towards improving medical practise. It's very hard for patients to differentiate between good doctors and bad doctors - and bad doctors can literally get away with murder. Expert , trusted , respected patients can rate doctors and provide an objective unbaised opinion as to the doctor's skills and competence. Word of mouth has always been one of the most effective techniques in rating doctors . So far, this was done informally and patchily. The net allows much better dissemination of information regarding a doctor's expertise and reputation.

Patient feedback will help to improve the medical services provided by doctors. Doctors who ask for cash under the table or those who order too many tests will be red-flagged in online discussions, so that patients can stay away from them. Doctors will also have to be on their best behaviour and treat all their patients as a VIP , because even one vocal unhappy patient can damage their digital reputation.

Online doctors will be able to learn from patient comments and feedback. They will be able to use other clinics as their benchmark, so that they can incorporate the best practises of doctors from around the world. This kind of online interaction can help good doctors to attract and treat patients from all over the world.

It takes a lot of work to establish a good online reputation and ethical doctors who spend the time and energy on doing so ( rather than in making the rounds of family physician to keep referring doctors happy) will find that this hard work pays off extremely well by providing them with a regular stream of satisfied patients !

HELP is offering grants to provide free websites for doctors . Millions of patients are already online, looking for good doctors – and we need to ensure that good doctors have an online presence, so it’s easy for patients to find them. We hope these websites will help good doctors to showcase their talent, and will allow them to grow their practice ethically. This will help patients as well , who will become aware of what services ethical doctors provide ,and what medical facilities are available in India.



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