Corrections or additions?
This article by Bart Jackson was prepared for the February 5, 2003 edition of U.S. 1 Newspaper. All rights reserved.
Doctoring Dotcom
You have exactly 200 seconds to present all your ills,
symptoms, and questions to The Doctor before he bolts from the
examining
room and sprints on to the next customer, leaving you naked on the
stainless steel examining table. Long gone are the days when a
physician’s
schedule permitted her to recall your name, let alone your health
history. Partly as a result of this de-personalization and time
pressure,
more than 67 percent of all American patients seek at least some
healthcare
advice on the Internet. The American Medical Association’s response?
Stop!
Is this a sound prescription? Are healthcare websites practical tools
or just a misleading overflow of information?
This issue comes up at “Healthcare and the Internet,” a
presentation
of the Princeton Chapter of the Society of Internet Professionals
on Wednesday, February 12, at 6 p.m. at Sarnoff. Cost: $10. Call
215-369-4866.
The featured speaker is Susannah Fox, research director for
the Pew Internet and American Life Project. Fox reveals exactly how
individuals seeking healthcare information are using the Internet,
and how businesses and information providers can best respond. Her
insights include issues of interest to healthcare professionals,
librarians,
and salespeople, as well as to website designers.
The Society for Internet Professionals (SIP) is a good deal less
frighteningly
techie than it sounds. Its membership includes writers, web designers,
programmers, marketers, and a range of business folk who want to make
the best use of Internet technology.
Joseph N. Pew, founder of Sun Oil, along with his wife, Mary Anderson,
raised four handsomely endowed children. In loving memory of their
parents, the two boys and two girls created several foundations,
which,
by 1979, they united into the Pew Charitable Trust. Designed to foster
citizen activity in health, culture, education, family, religion,
and the environment, the Philadelphia-based Pew Trust doles out $230
million annually from its $4.3 billion holdings.
Striving to keep up with the times, the trust in 1999 funded the
brainchild
of board member Rebecca Rimel: the Pew Internet and American Life
Project. Its goal is to find out just exactly what the Internet is
doing to — and for — us Americans. Through a series of rigidly
controlled studies and surveys, the Project seeks to compile data
on Internet use and its effect in a host of areas, including
healthcare.
Fox, the daughter of U.S. 1 Newspaper’s senior editor, Barbara Fox, is
a graduate of Wesleyan University, where she studied literature and
anthropology. She did research at the Harwood Group in Bethesda,
Maryland, before helping to launch RealNetworks in 1994. Armed with
this Internet experience, she moved to U.S. News & World Report, where
she was the editor of the publication’s online edition. Now it is
Fox’s job to help uncover and relate the effects the Internet is
having on society.
Sixty percent of all Americans over the age of 18 use the Internet,
Fox reports. While that percentage is growing scarcely at all, the
types of use have exploded exponentially. “Simply put, people
are growing more bold in their use of the ‘Net,” says Fox.
“Those
seniors who three years ago got online strictly to talk with the
grandkids,
are now shopping, selling, and checking out their latest medical
prescriptions.”
Like the public library, the Internet has now become a mainstream
information tool on which Americans depend. Additionally, trust in
the Internet has deepened enormously. Eighty percent of Americans
(greater than the actual number who use the ‘Net themselves) claim
that they expect to find — and do find — information vital
to their lives through the Internet.
In the face of this overwhelming usage, the American Medical
Association
has shifted its stance on the benefits of Internet health advice,
albeit grudgingly. Its 2001 proclamation warning Americans to get
offline was roundly criticized, and the organization was characterized
as a group of turf-threatened wizards vainly preaching that an
ignorant
patient was their best customer. This past year the AMA is addressing
the question of the quality of health information available online.
There is now a fairly even split between those patients who take their
initial health questions to a doctor, and those who turn first to
the Internet. Beyond looking at patient behavior, Pew’s research
includes
the patient’s “zone of influence” — the family members
and friends who are trying to act as advocates for the patient.
Patients
and their advocates alike tend to be discriminating in searching for
health information online. Fox reports that three out of four
individuals
searching for medical answers online have rejected at least some of
the information presented them. Why? And what makes one site highly
valued while another is rejected?
Those damn ads. The absolute number one reason patientsgive for rejecting medical advice provided online is their distrustof commercial advertising. While this probably surprises no one, itremains a blow to all the pharmaceutical and medical supply retailers,whose intent is, very reasonably, to sell their products.For years now website designers have answered the marketingprofessionals’requests to pack their sites with more information. They want to selltrust in themselves by making their web pages into learning tools.Yet all those fascinating diagrams showing medication moving throughvarious organs can be quickly undermined by a commercial message.Fox’s research show that the minute the company logo goes on and theorder slip appears, the effect of the advice is minimized.”Actually,”notes Fox, “it’s not all that bad. People love fact-based sites.All drug information is very popular. Designers must just rememberto keep the commercialism in balance. Pitch them at the end —not at the beginning.”Says who? “They” say that four glasses of bourbondaily will flush your kidneys just fine. Believe it? Probably not.The Internet “information,” while highly agreeable, citesno author, no journal, no specified source of validity. Recently theMedical Librarians Association came out with a list of three qualitychecks for all Internet information. First, check the source and theauthor. Second check the date. “If you log onto a website that’snot been updated since l999,” notes Fox, “you might find itunreservedly recommending hormone replacement therapy.” Finally,discuss all Internet findings with your doctor.The healthcare website that supplies information on its sources,carriesa current date, and suggests that patients check with their owndoctorsbefore taking action stands a better chance of getting read andbelieved.Feel of the familiar. If the medical advice agrees withsomething the patient has already heard from either a doctor, printpublications, or radio and television, the patient is more likelyto agree. The four-bourbon regimen, standing pretty much alone, willprobably not attract many disciples. Conversely, so much of the”new”dietary advice finds ready acceptance because it involves eating theway mom always told us to eat — lots of veggies and just asmatteringof sweets.Add backup, as any good propagandist will tell you, and credibilitygets a boost. One way to do this is to link to the websites ofestablishedmedical authorities. As a warning to patients, however, the MedicalLibrarians Association notes that medical information is oftensyndicated,so several sources may come from one study.Tyranny of the search engine. Over 85 percent of thoseseeking healthcare information online opt for standard search enginesover the medically validated search engines, including that of theNational Institute of Health (www.nih.org). Almost automaticallyAmericansclick on Google and type in “diabetes” and receive a floodof unedited information.The greatest quality problem with online healthcare research —and the one the public hears the least about — is the fact that,often, no one edits online material. Virtually all print media haveat least one editor who checks facts. The Internet itself has noeditor,and a particular website may or may not have an editor. “Thisquality control is definitely a problem,” says Fox, “but whenweb developers are armed with this knowledge, I feel they can designaround it.”Without a doubt, the Internet offers Americans greater access toinformationthan they ever had before. Fox tells the story of one elderly womanwhose paralyzed husband required a specialized air mattress, witha generator that died two days before Christmas. A phone call to thesupplier gave her only an “it’s out of date and Medicare won’tpay for it” response. Undaunted, the woman logged onto eBay, gota low-cost mattress generator, made a quick purchase, and had it sentby FedEx and installed by Christmas. Such is the power of the Internetto improve healthcare in unexpected ways.Are we better or worse off for the Internet’s invasion into our lives?With a sort of Buddha-like simplicity, Fox dismisses the black andwhite and responds: “You might as well ask if children half acentury ago were better or worse for the ballpoint pen.” For bothages, it is simply a fact of life — something there. Be it InstantMessaging or the pen, these are tools that our children find beforethem.Previous StoryNext StoryCorrections or additions?This page is published by PrincetonInfo.com— the web site for U.S. 1 Newspaper in Princeton, New Jersey.
