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Patient's Use of the Internet

Toronto, Ontario

Now that Internet access has become more commonly available, some patients are using this technology to assist in their medical care. The following story illustrates this point.

A middle-aged man noted that for several years food would get caught in what he believed to be a pouch in his esophagus. Although usually not a problem, he noted with increasing frequency that filling of the pouch would sometimes lead to vomiting in socially embarrassing circumstances. Not having a family doctor, he sought information on his condition via friends, relatives and the Merck Manual. Suspicious that the description of Zenker's diverticulum given there matched his condition, he then did a search over the Internet (using the Lycos search engine), and came upon a reference to Zenker's diverticulum in an article posted on GASNet. As a result, the patient contacted the author (DJD) by telephone seeking clinical advice. This information was provided informally, outlining what investigations might be done and providing the patient with the names of some clinicians known to be experienced in esophageal conditions.

This story illustrates some of the novel ways in which patients may sometimes acquire clinical information. As the Internet continues to increase in popularity, patients with Internet access will "surf the net" for information about their condition and be able to readily compare different management options. UseNet, discussion groups, and organization websites (e.g. the American Cancer Society) will allow those suffering from clinical conditions to receive medical information and even emotional support for themselves, their families and friends from those affected by the same medical problem. The impact of the Internet on public health can be enormous.

Patients, especially those from the United States, can also use the Internet to locate area physicians (e.g. through the American Medical Association website), check their credentials, and can even access disciplinary reports, malpractice judgments, and arbitration awards on a particular physician. Such data are often provided in the United States through state licensing authorities. One U.S. website (www.docboard.org), maintained by Administrators in Medicine (AIM), has links to 15 state regulatory bodies, including some osteopath and podiatry licensing bodies. Local magazines in many major U.S. cities (e.g. Minneapolis St. Paul Magazine, Boston Magazine) have published their surveys of best area doctors, often grouped by specialty. In Canada, the websites of licensing organizations will provide lists of member doctors, including those who are accepting new patients. However, these sites do not provide information on malpractice cases or disciplinary actions.

Some popular medical resources aimed at patients:

Yahoo! Health http://health.yahoo.com

WebMD http://www.webmd.com

Dr. Koop's Web Page http://www.drkoop.com

American Hospital Directory http://www.ahd.com

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