Sunday, August 14, 2005

Making intelligent use of the web - a patient's viewpoint

Here'a a thougtful and intelligent comment on how patients can use the web intelligently. This is a guest entry from a patient who prefers to remain anonymous.

Individuals need to source medical information from reputable websites.
Reputable medical websites include the following:

"HELP" - the free consumer health library that Dr Malpani, MD runs in Bombay. www.healthlibrary.com


Medscape free membership: becoming a member and receiving weekly Medscape Week in Review/Medpulse articles/newsletter includes Gynaecology section.

- A relevant recent article titled:

- Open Access Medical Publishing Is Finally Coming Alive by George D Lundberg, MD - Medscape

found on:
www.medscape.com/viewarticle/507380_print
Medscape General Medicine 2005 Posted 1st July 2005
talks about
open access publishing, first made possible by the Internet with full text published articles available free of charge to all - meaning free to doctor and free to patient.


Dr George D Lundberg, MD Editor in Chief, Medscape General Medicine quotes the following free resources in his References re: article he wrote:

1. Medscape Today. Available at:
http://www.medscape.com

2. PubMed Central FAQs. Available at: http://www.pubmedcentral.nih.gov/about/faq.html

3. The Free Medical Journals Site. Available at: http://www.freemedicaljournals.com

4. BioMed Central. Available at:
http://www.biomedcentral.com

5. PLoS Medicine. Available at:
http://www.plosmedicine.org

So, now that patient has medical information from above free reputable sources.....

The next thing is how does the patient best use medical information sourced from above websites?

I personally believe that the best way for a patient to use medical information obtained from the internet is solely for the purposes to find out more about the condition that their doctor has already diagnosed. As opposed to reading articles in order to diagnose a specific condition yourself. Remember you are the patient. Not the doctor. We go to doctors to diagnose us. We go the internet for more information about the doctor's diagnosis.

If this distinction is clear in your head, you will always find information on the internet useful, rather than confusing or scary.

Medical articles talk about things in general only. They are not applicable to a particular, specific person. However your doctor's diagnosis is specific to you.

I don't believe a patient can become a cyberchondriac from internet medical articles. A patient can take medical articles to their doctor for discussion during future doctor/patient consultations. It's very natural for a patient to wish to find out more about their diagnosed condition. There is not enough time during a patient-doctor consultation to discuss everything and also can't telephone a doctor each and every time a patient may have a new query about their particular condition.

The internet should supplement a "patient - doctor" visit. eg Rather than the doctor worrying that the patient is being misinformed by over abundance of an assortment of medical information available on the internet, the doctor can help their patient by recommending some good websites that their patients can go to for further information about their diagnosed medical condition/disease/ailment post consultation. It's too late to turn back the clock. Medical information is here to stay on the internet.

The best way for doctors to control the medical information their patients look at - is maybe to have their own website and describe common diseases/ailments/medications, procedures etc. That way the doctor can say to the patient at the end of the patient/doctor consultation: "Well Mary...if you want more information on eczema for example, just go to my website and you will find an abundance of information etc." That way the doctor can help to control what sort of information their patient actually looks at. Not all doctors though, have their own websites.

Even though patients may not have scientific/medical terminology, I think that most patients have common sense. ie Just because a patient may look at articles on the internet, and try to see how these may or may not relate to them, does not make them a cyberchondriac. In actual fact printing medical articles and bringing them in for discussion at next medical consultation may be mutually beneficial to patient and doctor.

Beneficial to patient because the patient gets what-ever out of their mind, and also beneficial to doctor, because the doctor has the chance to put what-ever into perspective for the individual patient. Additionally, should the doctor disagree with something in print, they have the obvious power to do something about it!! ie Write to the author of the medical article.

Sometimes, it's beneficial for the doctor to know what the patient is thinking. And by patient bringing in an internet article for discussion, the doctor has the chance to alleviate their patient's fears by saying - this or that does not relate to you specifically because of what-ever reasons. eg Article talks in general. "Not specifically to you - Mary" for example. Sometimes the patient can not express what they are thinking or feeling very clearly because they are nervous or embarrassed and sometimes an internet article can be an "ice-breaker" and even though sometimes the doctor may laugh about the internet article that the patient has brought in for discussion, the doctor at least is then aware of what is going on, inside of the mind of their patient. Because sometimes when a patient is not feeling too well, they can not articulate their concerns. Especially about embarrassing gynaecological matters (for example).

The most important aspect to remember when reading about medical articles on the internet is that they are just articles. They do not necessarily relate to you as an individual patient. Your own doctor has to examine you. However, once doctor has examined or assessed your own individual risk of a medical condition or has actually diagnosed you with a particular condition, the internet is a vast source of information that can make you feel a whole lot better, simply by being able to read more about your diagnosed condition.

As a patient, the more you know about something, the more empowered you may feel. I am sure that there are studies somewhere that show that the more a patient knows about their medical condition, the more better they may feel about it, just because of their increased knowledge of their medical condition, and this thereby may help their healing. (I'm sure there would be articles on the internet about this!!!)

To the doctors who may be infuriated about the cyberchondriac, I say to these doctors that such patients were already hypochondriacs long before free medical articles became available on the internet.

Also, the doctor has to remember that even though there are heaps of medical articles on the internet, the patient always knows only a fraction of what the doctor knows. The patient looking up medical articles is usually aware of this fact. ie I am always aware that no matter how much internet research I do about a particular medical condition, that my doctor will always know more about it, than me. The depth of knowledge that I know as a patient will always be a tiny fraction - compared to the depth of knowledge that my doctor knows about the same medical condition. Because, I, as a patient, know only through reading. My doctor on the other hand, knows from doing. From practice. From it being his lifelong profession.

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