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Doctors see some benefit from Net-searching patients

As more people go online for health information, physicians are finding that research can deepen levels of conversation during visits.

By Tyler Chin — Posted Aug. 15, 2005

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As the popularity of the Internet soared in the mid- to late 1990s, physicians feared that they would be inundated with irrelevant questions and questionable health information based on documents their patients would find on the Internet.

But for the most part, that fear has proven unfounded. The Internet has become a tool that, used properly, improves rather than harms physician efficiency, according to physicians and industry observers.

"I think that in some cases patients come in and you spend a lot of time trying to undo something that was erroneous that they saw on the Internet, but for the most part that's not true," said AMA Board of Trustees Secretary Joseph M. Heyman, MD, a solo gynecologist in Amesbury, Mass.

Today, 74% of American adults are online, compared with 38% in 1998, according to a Harris Poll released July 15. Of those who are online, 72% have searched for health information and 90% of them believe the information they find is either very or somewhat reliable.

Generally, patients who search for information online tend to be well-educated and have a medical condition or a family member with one, physicians say. Whether the information is reliable or off-the-wall depends on the patients themselves and the sites they visit, physicians say.

Meanwhile, doctors are referring patients to sites operated by specialty societies, academic medical centers, government agencies and organizations that focus on specific diseases. The AMA partly owns Medem, a San Francisco-based company that offers Web site services to physicians, including links to content written by medical societies.

"There's some very reputable sources out there on the Web," said Cheryl Lee, MD, a urologist and director of the Bladder Cancer Program at the University of Michigan Health System.

"Instead of being bombarded with questions or being bombarded with inaccurate and irrelevant questions, which I don't think has really been a big problem, you can potentially make office visits more efficient by directing patients to comprehensive Web sites that will answer a lot of the basic questions. So, I think that overall, as long as patients are being directed to the appropriate sites, it will actually save time or make the visits more efficient," Dr. Lee said.

Dr. Lee's study on the accuracy of online bladder cancer data was published in the November 2003 Journal of Urology. In that study, researchers led by Dr. Lee entered "bladder cancer" on several Internet search engines and came up with 240 links. Sixteen percent (38) of those links were unique Web sites, while the remainder were inaccessible, duplicates or contained only linked pages. Thirty-two percent of the unique sites had inaccurate information.

"Most of the inaccuracies were related to outdated information as opposed to, frankly, false information, which is encouraging in that it suggests that Web sites need to be updated more often," Dr Lee said. The Internet "is a great tool to be used and ... it's incumbent upon physicians to monitor medical Web sites or medical information sites" so they can direct patients to reliable ones.

Site selection is crucial

Maureen Levy, MD, an internist and pain-management specialist in Tampa, Fla., refers patients to sites developed by academic medical centers because they are reliable and have science behind their content. "I find that encouraging your patients to do as much research about their illness is better for the physicians because the patient comes in with a better knowledge base," she said.

Still, the quality of information on the Internet can be dubious. "Some of it is valid and some of it is pretty far off," Dr. Levy said. "But I'd say nowadays that when people are really interested in their disease they are more likely to go [online], and when they come back [to see me] they really have more information. They have more questions, but it tends to be more focused. Rather than ask what's wrong with them, they will ask, 'Well, if this happens and this happens, does that mean that this will also happen to me?' So the conversation goes better."

If her patients aren't searching for information online, their teen and adult children are, Dr. Levy said, adding that sometimes "their kids will take over the conversation."

"They never made any comments before. Now, they are more involved because they are doing the look-up for their family," she said.

Andrew Baumel, MD, a pediatrician at a six-doctor pediatric group in Framingham, Mass., said a minority of his patients' families research information on the Web before they visit him. Instead, Dr. Baumel said, often he will use a computer in his practice to show parents certain Web sites he believes are reliable. Dr. Baumel is one of many physicians who give "information prescriptions" -- handing patients a list of preferred Web sites.

Whatever the source of information, the trend toward a better-informed patient is good for medicine, Dr. Heyman said.

"Patients should share in the responsibility, opportunities and decision-making that is associated with medical care, because I think it provides better medical care."

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ADDITIONAL INFORMATION

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Most American adults are online, and almost three out of five say they seek health information. A June telephone survey of 1,015 U.S. adults found the percentage of all American adults who are online hit 74% (117 million) in 2005 compared with 69% (111 million) in 2004.

2003 2004 2005
Adults online 67% 69% 74%
Have searched for health information 78% 74% 72%
Look for health or medical information often or sometimes 54% 50% 58%
Discuss what they find online with their doctor NA NA 57%
Have searched for information online following a discussion with their doctor NA NA 52%
Believe online health information is very or somewhat reliable NA NA 90%

Source: Harris Interactive survey, July 15

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Top sites

The five most-used health information sites for June, based on the number of unique visitors:

WebMD 10,964,000
National Institutes of Health 7,378,000
eDiets 6,731,000
America Online Health 4,211,000
Weight Watchers International 3,605,000

Source: comScore Media Metrix

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