Where to go for medical advice on the Web.

Will the Web Make Us Better Patients?
June 13 2000 5:41 PM

Where to go for medical advice on the Web.

VIEW ALL ENTRIES

An excellent place to start, David. You've zeroed right in on the ambivalence doctors often feel about all the random information sloshing around out here on the Internet. I've had many of the exact same feelings, but like you seem to, I wonder how much our concerns make sense when we scrutinize them more closely.

Advertisement

You begin with two extremely interesting cases that are worth dissecting for a moment. It might help us figure out what we are looking for as we shop the Internet's health & beauty aisles. The first thing that struck me about your cases, the cases of Mr. Psoriasis and Mrs. Mohs, was that they actually got pretty decent information off the Web. They just used it badly. The second thing was that either case could have happened no matter where they got their advice--whether from onhealth.com, a TV ad, or old Uncle Flatus who says he used to be a dermatologist in Albania. People have gotten bad advice, and used good advice badly, for centuries. The question is whether there's anything special about the Internet version.

I can think of at least two reasons we might be particularly concerned about medical Web sites. One is if they provide new ways to circumvent basic protections in our health system against harm--for example, providing potentially dangerous prescription drugs to people sight unseen. Fortunately, none of the Web sites we're looking at do these sorts of things.

The second concern is whether information anarchy (I'm not sure it's quite yet a democracy) will turns out, on the whole, to be bad for people. It's not inconceivable, although it would surprise me. The only study I know of that attempts to answer this question was a randomized study of 40 women with invasive breast cancer. The researchers gave half of them home computers with access to medical staff by e-mail, patient discussion groups, and Web site information. And compared with the control group, these women had significantly less depression, anxiety, and distress about their condition. But the study was unfortunately way too small to measure any actual cancer outcomes.

I'm going to take it as a given--and I suspect you will agree with this--that the medical Internet will turn out to be at least neutral overall for people's well-being. What I think is cool, though, are all the different ways in which the Internet could transform public health for the better. Providing basic medical information, which is what all the Web sites we're looking at do, seems like only the simplest level. It is certainly fine and dandy, but it's also incredibly boring--sort of like encyclopedias. Now, I love a good encyclopedia, and I suppose we'll have to spend some time sorting out for people which one seems like the best one, but who wants to spend a full week reviewing encyclopedias? (My vote so far, by the way--and it's not without qualms--is for drkoop.com. And yours?)

Much more interesting would be if the Web sites actually helped people figure out not how to be a doctor but how to get more out of the doctors you see. Rate them. Provide clues about what to look for when you're getting snowed and when you're getting reasonable care. Offer access to the gossip, both good and bad, that their patients have about them. My experience is like yours in that most of the patients I see feel no compulsion to control much of their care. They simply want a doctor. You mentioned the art of medicine, the art of doctoring, and what's striking is that there is now an art to being patient, too. Patients have to know when to assert themselves and know when to trust.

Now, do any of the Web sites actually provide clues about how to know this? That seems like a question worth getting into.

TODAY IN SLATE

History

Slate Plus Early Read: The Self-Made Man

The story of America’s most pliable, pernicious, irrepressible myth.

Rehtaeh Parsons Was the Most Famous Victim in Canada. Now, Journalists Can’t Even Say Her Name.

Mitt Romney May Be Weighing a 2016 Run. That Would Be a Big Mistake.

Amazing Photos From Hong Kong’s Umbrella Revolution

Transparent Is the Fall’s Only Great New Show

The XX Factor

Rehtaeh Parsons Was the Most Famous Victim in Canada

Now, journalists can't even say her name.

Doublex

Lena Dunham, the Book

More shtick than honesty in Not That Kind of Girl.

What a Juicy New Book About Diane Sawyer and Katie Couric Fails to Tell Us About the TV News Business

Does Your Child Have Sluggish Cognitive Tempo? Or Is That Just a Disorder Made Up to Scare You?

  News & Politics
History
Sept. 29 2014 11:45 PM The Self-Made Man The story of America’s most pliable, pernicious, irrepressible myth.
  Business
Moneybox
Sept. 29 2014 7:01 PM We May Never Know If Larry Ellison Flew a Fighter Jet Under the Golden Gate Bridge
  Life
Dear Prudence
Sept. 29 2014 3:10 PM The Lonely Teetotaler Prudie counsels a letter writer who doesn’t drink alcohol—and is constantly harassed by others for it.
  Double X
Doublex
Sept. 29 2014 11:43 PM Lena Dunham, the Book More shtick than honesty in Not That Kind of Girl.
  Slate Plus
Slate Fare
Sept. 29 2014 8:45 AM Slate Isn’t Too Liberal, but … What readers said about the magazine’s bias and balance.
  Arts
Brow Beat
Sept. 29 2014 9:06 PM Paul Thomas Anderson’s Inherent Vice Looks Like a Comic Masterpiece
  Technology
Future Tense
Sept. 29 2014 11:56 PM Innovation Starvation, the Next Generation Humankind has lots of great ideas for the future. We need people to carry them out.
  Health & Science
Medical Examiner
Sept. 29 2014 11:32 PM The Daydream Disorder Is sluggish cognitive tempo a disease or disease mongering?
  Sports
Sports Nut
Sept. 28 2014 8:30 PM NFL Players Die Young. Or Maybe They Live Long Lives. Why it’s so hard to pin down the effects of football on players’ lives.