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This article by Bart Jackson was prepared for the February 5, 2003 edition of U.S. 1 Newspaper. All rights reserved.
You have exactly 200 seconds to present all your ills,
symptoms, and questions to The Doctor before he bolts from the
room and sprints on to the next customer, leaving you naked on the
stainless steel examining table. Long gone are the days when a
schedule permitted her to recall your name, let alone your health
history. Partly as a result of this de-personalization and time
more than 67 percent of all American patients seek at least some
advice on the Internet. The American Medical Association’s response?
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
of the Princeton Chapter of the Society of Internet Professionals
on Wednesday, February 12, at 6 p.m. at Sarnoff. Cost: $10. Call
The featured speaker is
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,
and salespeople, as well as to website designers.
The Society for Internet Professionals (SIP) is a good deal less
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,
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
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
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.
seniors who three years ago got online strictly to talk with the
are now shopping, selling, and checking out their latest medical
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
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
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
the patient’s "zone of influence" — the family members
and friends who are trying to act as advocates for the patient.
and their advocates alike tend to be discriminating in searching for
health information online. Fox reports that three out of four
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?
give for rejecting medical advice provided online is their distrust
of commercial advertising. While this probably surprises no one, it
remains 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 marketing
requests to pack their sites with more information. They want to sell
trust in themselves by making their web pages into learning tools.
Yet all those fascinating diagrams showing medication moving through
various organs can be quickly undermined by a commercial message.
Fox’s research show that the minute the company logo goes on and the
order slip appears, the effect of the advice is minimized.
notes Fox, "it’s not all that bad. People love fact-based sites.
All drug information is very popular. Designers must just remember
to keep the commercialism in balance. Pitch them at the end —
not at the beginning."
daily will flush your kidneys just fine. Believe it? Probably not.
The Internet "information," while highly agreeable, cites
no author, no journal, no specified source of validity. Recently the
Medical Librarians Association came out with a list of three quality
checks for all Internet information. First, check the source and the
author. Second check the date. "If you log onto a website that’s
not been updated since l999," notes Fox, "you might find it
unreservedly recommending hormone replacement therapy." Finally,
discuss all Internet findings with your doctor.
The healthcare website that supplies information on its sources,
a current date, and suggests that patients check with their own
before taking action stands a better chance of getting read and
something the patient has already heard from either a doctor, print
publications, or radio and television, the patient is more likely
to agree. The four-bourbon regimen, standing pretty much alone, will
probably not attract many disciples. Conversely, so much of the
dietary advice finds ready acceptance because it involves eating the
way mom always told us to eat — lots of veggies and just a
Add backup, as any good propagandist will tell you, and credibility
gets a boost. One way to do this is to link to the websites of
medical authorities. As a warning to patients, however, the Medical
Librarians Association notes that medical information is often
so several sources may come from one study.
seeking healthcare information online opt for standard search engines
over the medically validated search engines, including that of the
National Institute of Health (www.nih.org). Almost automatically
click on Google and type in "diabetes" and receive a flood
of 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 have
at least one editor who checks facts. The Internet itself has no
and a particular website may or may not have an editor. "This
quality control is definitely a problem," says Fox, "but when
web developers are armed with this knowledge, I feel they can design
Without a doubt, the Internet offers Americans greater access to
than they ever had before. Fox tells the story of one elderly woman
whose paralyzed husband required a specialized air mattress, with
a generator that died two days before Christmas. A phone call to the
supplier gave her only an "it’s out of date and Medicare won’t
pay for it" response. Undaunted, the woman logged onto eBay, got
a low-cost mattress generator, made a quick purchase, and had it sent
by FedEx and installed by Christmas. Such is the power of the Internet
to 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 and
white and responds: "You might as well ask if children half a
century ago were better or worse for the ballpoint pen." For both
ages, it is simply a fact of life — something there. Be it Instant
Messaging or the pen, these are tools that our children find before
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