Are You an Internet-Friendly MD?

Fourth and last of a series, from my lecture “Dealing with Patients Who Surf the Net” at the 2011 Philippine College of Physicians Annual Convention last May. Available at Slideshare.net.

““[Most doctors] really do like to think they have ALL the answers. This will never change, I am afraid.”

Quote from a Patient in the Pew Internet Project e-Patient Survey

 Are you an internet-friendly or an internet-hostile doctor? Does it make you uncomfortable that patients will seek a “second opinion” online? Do you feel offended by the patients’ attempts to learn more online? I hope not.

Like it or not, patients are now more likely than ever to search for health information online. I try my best to be as internet-friendly as I can in my endocrine practice. I often find myself giving internet prescriptions for uncommon endocrine disorders:

1. www.pituitary.org – This is the website of the Pituitary Network Association. It has a very helpful FAQ section for the different pituitary disorders.
2. www.hormone.org – This is the website of the Hormone Foundation, an affiliate of the Endocrine Society. It has very useful Fact Sheets and Patient Guides.

In my lecture at the Philippine College of Physicians annual convention, I highlighted the following more general websites:

1. MedlinePlus – It not only has good articles on the different medical conditions but has a section on Drugs, Herbs and Supplements.
2. Mayo Clinic – The site has a Symptom Checker and information on how different tests and procedures are done so patients can be prepared properly.

During the clinic encounter, the opposite also happens where the patients recommend that you read this or that website so you can inform them if the website is accurate or not. Since obviously I may be too busy to check it out, I usually just reply by asking them to look for the HON (Health on the Net) Code seal on the website.

“HON was founded to encourage the dissemination of quality health information for patients and professionals and the general public, and to facilitate access to the latest and most relevant medical data through the use of the internet.”

Health on the Net Foundation

According to the HON website, the HON code is stamped on more than 10 million pages covering 102 countries. A website is given HON certification if it adheres to the following principles:

1. Authority – gives qualification of authors
2. Complementarity – information to support, not to replace
3. Confidentiality – respect the privacy of site users
4. Attribution – cite the sources and dates of medical information
5. Justifiability – justification of claims/ balanced and objective claims
6. Transparency – accessibility, provide valid contact details
7. Financial disclosure – provide details of funding
8. Advertising – clearly distinguish advertising from editorial content

The Health on the Net Foundation does have a disclaimer though –

“HON cannot guarantee the accuracy of medical information presented by a site and its completeness at any given time, but possession of the HONcode seal allows a site to demonstrate its intention to contribute to quality medical information through the publishment of objective and transparent information.”

 

Finally, some thoughts to ponder from a white paper:  Tom Ferguson, MD & the e-Patients Scholars Working Group (2007), “e-patients: How They Can Help Us Heal Healthcare.” First, do not underestimate the patient’s ability to provide useful online resources. The paper points out that some of the best health-related websites have been made by patients! These websites often offer helpful information that physicians may think less important to discuss i.e. tips for coping and living with the disease. And secondly, do not overestimate the hazards of imperfect online information. The paper cites the Database of Adverse Events Related to Internet Use (DAERI) which reported only a single case of possible fatality as of 2004, in its four years of existence. This project which offered a fifty-euro reward for each case reported was eventually shelved for lack of cases reported.

Image credit: http://www.flickr.com/photos/caricaturesbynelson/2031107541/