Maybe LGND does need a web page. The could have an entire section on indications for their pipeline: November 19, 1997
Doctors Face Newly Knowledgeable Patients As Consumers Learn on the Net
By SANDEEP JUNNARKAR
ith the help of the Internet, Mallory Marshall feels she may have saved her husband's life.
When her husband, Peter Haffenreffer, was recently diagnosed with prostate cancer, she logged onto the World Wide Web and quickly learned how to search for medical papers and new research, and personal sites where people relate their own experiences with their illness.
"We became very well-informed," Marshall said. "With the information I dug up, we went all over the place to interview different doctors and compared different therapies ranging from radiation, diet, surgery and 'seed' implants."
Marshall is not alone in turning to the Internet for medical information. The Net is playing an increasingly greater role as more patients log on to help them make health care and treatment decisions, with some physicians even beginning to prescribe specific Web sites.
"If a patient is interested in all the details of an illness, we refer them to sites on the Web," said Robert Sikorski, a doctor at the National Cancer Institute. Sikorski helped create MedsiteNavigator, a search engine devoted to medicine and science. "It's the best way for them to get basic information at their own pace."
For example, at the American Heart Association site, patients can find a Heart and Stroke A-Z Guide, which provides easy to understand information on a topics that include arrhythmia and low-cholesterol diets. The American Academy of Allergy, Asthma and Immunology site provides useful information, including how to discover common food allergies, and precautions asthmatics can take for different weather conditions. And the National Cancer Institute has pages devoted to different illnesses, including prostate cancer.
"The reason these sites are important is that they enable patients to be informed consumers of their physicians recommendations," said David Blumenthal, a physician at Massachusetts General Hospital in Boston and an associate professor at Harvard Medical School. "The information can help them to ask the right questions and to access whether the physician is competent to care for them."
In the latest issue of The Journal of the American Medical Association (JAMA), released on Tuesday, Blumenthal addresses the issue of patients' gaining medical knowledge from the Internet. While he says that the technology will fundamentally alter health care in the future, he also warns of side-effects.
Blumenthal said he was concerned with how medical services will evolve as two classes of patients are created: the computer literate and the information disabled. His article examines the evolution of this two-tiered health care system. One level of care will be aimed at the informed consumer, providing care sensitive to the patient's desires. The other system, he says, will have physicians and providers that are less nimble and more paternalistic toward patients.
Most people, however, agree that the Net will benefit both patients and physicians.
Haffenreffer and Marshall said they based their health care decisions on the discussions they had with their doctor and the knowledge they gained from the Internet.
"We could not have gone down this road without this resource," Marshall said. "It gave us a sense of personal power and integrity, left us feeling educated and somewhat calm about the choices we made."
But as she and her husband found, not all physicians are pleased when their patients start quoting medical references.
"It is a much less comfortable relationship for doctors because you have to be smart all the time. Till now, we knew that the patient didn't know what we know. That was the source of our ego," Blumenthal said. "Now, many patient encounters are going to be instances where we are going to have to apply our general intelligence to a set of information that we know better in most cases but in some, the patient may know a little more than us."
Until recently, it was only the patients who suffered from rare illnesses who were likely to know more about their illnesses than a doctor because of the years of research and dialogue with different specialists.
"You don't have to live with an illness for a long time to know a great deal about it anymore. That's what the Internet has done," Blumenthal said. "It's not that the information was not available, it was just a lot harder to find and it took a lot more ingenuity and time."
Some physicians may not fear for their egos because of patients armed with reams of research. What they fear in this age of cost-efficient managed care is having to spend more time with patients who are asking more questions and questioning more answers.
"Physicians are struggling more than patients in how to deal with Web information," Sikorski said. "They are worried that they may end up spending a lot more time educating patients who have access to a lot of information without knowing what is credible and what is wrong."
To avoid misinformation, Sikorski recommends that patients stick to the sites affiliated with medical schools, and university and government research institutes. A good reputable starting point is the U.S. Government's Healthfinder site. Healthfinder collects links to high-quality medical information on the Web.
Marshall, who returned home after her husband's treatment at Johns Hopkins' Brady Urological Institute on Saturday said: "The positive effect this will have on the medical community ultimately is that the people who use the Internet to become educated about their own illness are going to be able to make better use of their doctor's time and doctors are going have to learn how to fully address their patient's concerns and questions again."
Related Sites Following are links to the external Web sites mentioned in this article. These sites are not part of The New York Times on the Web, and The Times has no control over their content or availability. When you have finished visiting any of these sites, you will be ableto return to this page by clicking on your Web browser's "Back" button or icon until thispage reappears.
MedsiteNavigator
American Academy of Allergy, Asthma and Immunology. The site has a glossary to help sift through all the medical jargon.
Prostate cancer pages at the National Cancer Institute
Journal of the American Medical Association
David Blumenthal 's article
U.S. Government's Healthfinder
Johns Hopkins' Brady Urological Institute
Sandeep Junnarkar at sandeep@nytimes.com welcomes your comments and suggestions. |