Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Monday, October 17, 2005

‘Dr. Internet’ exasperating to MDs

Posted on Sun, Oct. 16, 2005

‘Dr. Internet’ exasperating to MDs

By Shari Rudavsky

Indianapolis Star

CARMEL – The patient walked into Hamilton County physician Matthew Nelson’s office, announced he had looked up his symptoms online, determined he had Lyme disease and demanded specific antibiotics to treat the malady. Nelson, with years of medical training, could only sigh. He’s all too familiar with patients who go online to self-diagnose.

“In the past, we actually looked at your symptoms and tried to diagnose you,” says Nelson, an internist and pediatrician at Riverview Hospital in Noblesville with a practice in Carmel. “Now I have to de-diagnose the patient and say these are probably the reasons you don’t have this.”

With more people turning to “Dr. Internet,” experts urge caution in consulting the Web for medical or health information. Although many sites offer sound information, just as many sell a product, promote a controversial view of an issue or provide outdated or wrong information.

Still, that doesn’t stop people from looking.

A study published this year found 41 percent of 2,007 people interviewed in a telephone survey – and 56 percent of those who used the Internet – had searched for health or medical information in the past year.

Seventy percent of those surfers asked about a specific problem, according to the study, which appeared in August in the International Journal of Medical Informatics.

Since surviving a heart attack last January and discovering that she had diabetes, Mary Margaret Wisner goes online often to learn about her conditions.

Some days, Wisner, 57, visits Irvington Internet, a cafe her son co-owns, to search for tips on what to eat or alternative products to take, information her doctors have not given her.

Still, she always checks with her doctor or pharmacist.

“I don’t just take it as the gospel truth, but I don’t do that with the doctor, either,” the Indianapolis resident says. “I wouldn’t know anything if it were up to my doctors; 95 percent of what I know as to how to take care of myself, I learned from the Internet.”

Physicians, however, need not worry about the Internet supplanting their expertise, the study found. Of those who looked for health information on the Internet, 55 percent contacted their physician afterward.

“Health-care information online seems to be an adjunct to health care; people are using it as one tool among many,” says Michele Ybarra, an author of the study and president of Internet Solutions for Kids, a non-profit group in Irvine, Calif.

People between the ages of 40 and 60 relied on the Web the most as a health information resource.

Because that age range has the most caregiving responsibilities – for their kids and their parents – it’s not surprising they’re the most likely to look for such information, Ybarra says.

Patients go online to check out a drug’s side effects, to learn more about a condition they already have, to find others who share their disease or to try to diagnose themselves.

So does the Internet make a doctor’s job harder or easier?

“I think it does both,” says Dr. Lisa Richter, a doctor at Speedway Family Physicians, a Westview Hospital clinic. “It definitely gives patients another avenue, but sometimes it makes them too aware of things.”

Laypeople have always been able to go beyond what their doctors have told them in the search for more medical information, checking out books or journals aimed at professionals. The Internet has made the practice that much easier and – with its rash of Web sites – much more complicated.

“It takes a lot more work to wade through the information to sort out the good from bad,” says Dr. Michael Weiner, a scientist with the Indiana University Center for Aging Research and the Regenstrief Institute. “We know most Americans have access to health information. Whether they’re good at sorting it out remains to be seen.”

That’s why some professionals, such as Dr. Matthew Surburg, have taken matters into their own hands. Surburg, a family medicine physician with Hancock Family Practice in Greenfield, hands patients a form letter advising them how best to use the Internet to answer medical questions.

Some sites do a better job of helping the viewer do that than others, notes Dr. Stephen Barrett, a retired psychiatrist in Allentown, Pa., who operates the site He recommends sites that offer filtered information rather than just presenting a study’s results.

“What you ought to try to do is go to sites that fit everything together,” he recommends.

Real-life physicians have another advantage over their cyber versions, Surburg says.

“Even a reliable site still doesn’t take the place of a physician’s input because the Web site can’t examine you and integrate everything into one picture.”

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