Medicine on The Net

Finding good sources and avoiding bad ones.

Anyone with a computer and an internet connection can develop a web-site. That's wonderful, isn't it? All that publishing freedom is out there just waiting for users. Just look at us!

One of the most popular site themes (after politics and the other "p") is health maintenance in any of its many forms. These range in style from professional to puerile, including such points of emphasis as advocacy and support groups for patients with specific conditions. Then, of course, there are literally thousands of sites with things for sale. Their wares are primarily in the "alternative" category, and include herbs, ancient Chinese or Indian stuff, vitamin and supplement lines, and anything which could be classified as "natural".

For anyone seriously searching for help, is there a way to navigate the minefield safely? How reliable is THIS web-site, for example? Medical and scientific journals uniformly make use of "peer review" before publishing articles submitted to them. Since there is no agency or person designated to review anything on the Internet, or to establish and maintain standards, let the user beware!

Here are ten suggestions for personal web-search quality control(no apology to Letterman):

1. If you happen upon a site where the term "scientific breakthrough" is used, read with skepticism. If that term is used more than once, close the window immediately.

2. Beware of home pages with gaudy colors and garish pictures unless they are produced by someone you know and like, and are intended for use by children.

3. Steer clear of anyone who claims that the FDA is, in league with the pharmaceutical industry, keeping their site's product from the public (with consequent extreme suffering and / or loss of useful life).

4. The following statement - "Doctors are controlled by the AMA, which is prejudiced against our line of ---- (vitamins, supplements, etc.)" is hogwash. The AMA has been a force for improving standards of medical care, but it only encourages doctors to practice good medicine. State licensing boards are the governing agencies for quality of care, which is the product of peer review and local professional associations.

5. Most mavericks are out of the main stream for good reasons. Rarely if ever is one of them likely to offer something superior to the standard product.

6. Testimonials are fine in church, but have little value in determining the worth of a specific treatment or drug. Sometimes they're fun to read if you have nothing better to do.

7. The value of a substance is inversely proportional to the number of places advertising its sale (see "bee pollen").

8. If you perceive a strong "them against us" mentality pervading a web-site, cross it off your list.

9. Never give your credit card information to a site with "all natural ingredients" anywhere in their subject matter.

10. Good healthcare resource web-sites will have links to others of similar quality. The reverse is true for bad sites.

Medical schools, major clinics (Mayo, Ochsner, Cleveland, eg), the National Institutes of Health, and disease specific agencies (heart, lung, or cancer societies) have material which is reliable, accurate, and usually well-presented. One can also find on these sites links to support groups or printed material sources for patients.

With proper use of the Internet, patients can broaden their medical knowledge base, and become better "consumers." The rewards in terms of health maintenance are obvious. Net-based education is also an economically positive thing. Smart patients know when they have to see the doctor, and, more importantly, when they don't.