Reply to comment

      With the age of information technology upon us, the way people search for the information they need is drastically changing. One of the most influential causes of such change was the creation of the Internet. Information that has historically been difficult to access, or only accessible to certain sections of society, is suddenly available to the general public in a matter of seconds. While the effects of the Internet have been widespread, one sector that has been significantly impacted is health care. Before the only way for people to get reliable information about their health and well being was to visit their doctors office, and have a personal consultation. While there were medical books, written by doctors and other medical professionals, and sold to the public, these books contained relatively basic information. However, since the creation of the Internet, the plethora of information available to the general public, much of which was written with health professionals, and not the general public, in mind, has become potentially dangerous. One must take into consideration the differences between sites designed for use by medical professionals, and sites designed for use by the general public. While the basic information may be the same, the information for professionals is going to be much more technical, and therefore much more difficult for the general public to understand. Information intended for the general public, however, may not be as reliable, depending on the source the individual is using. As a result, the general public has started search websites designed for use by health professionals, which has the potential to be a problematic practice.

     According to one study, 75% of individuals surveyed reported searching for medical information on sites geared towards medical professionals (McMullan, 2006). The reasons cited were the preference for more complex information (80%), and that information on other sites is too basic (45%). While 86% of individuals said they also performed additional searched to clarify the information, only 32% said they would ask their doctor for clarification (McMullan, 2006). While in some circumstances, such as searching for a well-known disease that lots of conclusive research has been done on, these searches can be quite helpful, and not at all detrimental to the patient. Unfortunately, this is not always the case. This survey also found that 31% of individuals found the information overwhelming, and 27% found it confusing (McMullan, 2006). The more worrying statistic, however, was that 76% of individual found the information to be conflicting. When a patient finds two conflicting pieces of information about a particular disease online, it is incredibly unlikely that they will be able to determine by themselves which piece of information to rely on, and which to disregard. Such conflicting information is most likely to be found on most sites, regardless of whether or not they are geared towards medical professionals or not. For sites geared towards professionals, this conflicting information is most likely to the fact that it is a rare occurrence when two studies produce the exact same results. When health professionals look at such sites, they understand this, and it is their job to come to their own conclusion from the data presented. However, when the general public is looking at the same data, it is unlikely that they will be scientifically literate enough to comprehend the data, and to make a valid conclusion based on it. Ideally, this would encourage patients to go to their doctor’s office for clarification. However, this too presents a problem as it leads to doctors spending significantly longer with the patient than they would have otherwise. Additionally, it is unlikely that the doctor will be able to help the patient understand this information completely. As a result, the patient will be more confused, even after a doctor’s visit, than they would have been if they had stayed away for such Internet health information.

     Another potential problem with patients accessing Internet health care information that is designed for the use of physicians is when patients do research on a treatment for a particular disease. Studies about new, experimental, and potentially dangerous treatments for diseases are being published on a daily basis. Due to the demand on their time, it is unlikely that physicians would be able to read such papers as soon as they come out. While doctors should be as up to date as possible on potential treatments, some studies are so inconclusive that it would be a waste of the physicians time to read it, as another study will be published in a few months that will completely debunk the previous study’s conclusions. While physicians are well educated enough to tell the difference between online information that is worth their time, and information that is not worth their time, patients that have access to the same information most likely do not have the same ability. Instead, they will end up reading about unproven, and potentially dangerous, treatments that they then present to their physician. In the case of sites that are geared towards the general public, however, it is much less likely that information on such treatments will be available. While there will certainly be information on treatments that are not practical for a particular patient, the number of potential treatments will most likely be significantly less. As a result, physicians will spend less time correcting any misinformation that patients may have found.

     The general public having access to sites designed for use by medical professionals is not entirely a bad thing. While the entire population does not have the ability to correctly interpret the data they find, there are many people who do. For such individuals, they can interpret the data much as their physician would, and can therefore make valid conclusions about what information they should rely on, and what information is not relevant to them. This would most likely result in their spending less time in their doctor’s office discussing impractical treatments, and will increase the quality of their care. Such a situation would be greatly beneficial to both the patient and the provider. Additionally, if the general public suddenly starts perusing medical journals that they’ve found online, this may force physicians to stay up to date on the relevant information that has been published online. While this would result in physicians sending more time doing research online, and potentially less time with their patients, the improvement in the care that they are able to give to their patients is most likely worth it.

     Due to the fact that many individuals have expressed dissatisfaction with the health information that is designed for their use, several sites have emerged that are an intermediate between the sites previously available. One such site is MEDLINEplus (Lindberg, 2001). The US government has been making an effort to keep patients off of sites designed for professionals, and as a result have designed a website that is geared towards the general public with understandable, yet still somewhat complex, health information. It was designed in order for “health care providers and the general public alike have access to an unbiased, noncommercial source of medical information.” (Lindberg, 2001) As an offshoot from the National Library of Medicine’s very popular web site MEDLINE, this site is seen as in incredibly reliable source of information. The hope in creating such a site was that it would provide patients with the peace of mind that the information they are accessing is reliable, and to steer them away from accessing information that they do not have the ability to interpret correctly. However, this does not necessarily provide doctors the peace of mind that they will not have to spend too much time correcting patients misinterpret, as there is still the possibility that this information can be misinterpreted, it is just more likely that the information is reliable, so the site should hopefully cut down on the amount of time that doctors have to spend correcting their patients misinterpretations.

      When searching the Internet for medical information, the type of website that the information comes from can play a crucial role in whether or not the information is useful or not. With more and more websites that are geared towards medical professionals being accessed by the general public, the fear is that patients will end up confusing themselves with this information, and the affects on their health will be detrimental. However, with many individuals feeling that the websites that are designed for their use have conflicting, or too basic information, they are forced to look elsewhere to find answers to their questions. Often the next step they take is to visit sites where the information is most likely much too complicated for them to utilize it properly. While there are a few sites, such as MEDLINEplus, which are designed as a compromise between the two other types of sites, they are few and far between. And, while these sites are useful, they currently only have information on a handful of diseases. In order to deter patients from visiting sites that are not designed for their use, there needs to be more information available that not only satisfies the publics desire for more complex information, but that is not so complex that they can not interpret it. While this is a very fine line, if such a site can be achieved, and it contains a plethora of information on thousands of diseases, it could be a valuable tool that leads to significant advances in modern health care.

Works Cited
Lindberg D. The National Library of Medicine's Web Site for Physicians and Patients. Journal of the American Medical Association 2001;285(6).
McMullan M. Patients using the Internet to obtain health information: How this affects the patient-health professional relationship. Patient Education and Counseling 2006;63:24-28.