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(17) 1 Feb 2010

Doctor Google and the Internet Prescription

During a recent medical conference in Brazil, I came across a magazine whose cover article title was “Doutor Google”. While there was no English text and my understanding of Portuguese is limited to words that resemble Spanish, it was clear that the article was about medical information on the Internet. The crux of the article was that patients often seek out health information on the Internet before they see their physician.

The roots of the Internet go back to the early 1970’s as a US Defense Department initiative known as ARPANET that linked government and university computers to create a communications system that would survive a nuclear strike. With funding from the National Science Foundation in the 1980’s, the academic network rapidly expanded. In the 1990’s, the Internet as we know it today, was supplanted with non-governmental service providers supplying the network backbone. The original Defense Department context had evolved into a global information and communications resource used by governments, businesses, academic institutions and individuals alike.

Health care providers commonly use the Internet as a invaluable tool for obtaining the latest research and treatment information in addition to its utility in communicating with colleagues and patients alike. Almost every medical textbook and recent journal article can be accessed in some fashion through the Internet. Step by step details and videos of surgical procedures can be found. What used to require a trip to the local medical school or public library to obtain information about a medical topic, practitioners and patients alike can now retrieve the same technical, up to date medical information with a few mouse clicks from almost anywhere in the world.

The Internet has created new opportunities and a unique challenge in health care. Patients are able to consult on line, often outside of the regulatory protection that their state or country may provide. Patients may self treat through the seemingly unrestricted on-line purchase of prescription medications. The Internet represents a new aspect of medical care for physicians in diagnosing, treating, educating, and counseling their patients in the information age.

The utility of this incredible and unprecedented Internet resource can actually be hampered by the massive number of sites available. A recent Google search of the term “prostate cancer” led to over 10 million web sites in less than a quarter of a second. A search for “urinary incontinence” returned almost 2 million sites. In addition to the potential for information overload, care must also be given to the credibility of any information provided on the Web.

Providing written information or customized handouts for patients has been a longstanding medical practice. With the growth of the Internet as a powerful medical resource, we must consider how best to use this tool. The empowered patient is an important ally in improving the quality of health care. However, too much information, misinterpretation of information or conflicting information on the Internet can be overwhelming, confusing, and sometimes anxiety provoking especially for a patient dealing with a newly diagnosed medical problem.

How can we best use the Internet as an effective medical resource for our patients? Practitioners should consider suggesting appropriate websites that contain reliable, patient centric information consistent with the patient’s disease state and prescribed treatment plan. This concept of the health care provider generated “Internet Prescription” has merit in the information age. Providers should consider giving this “prescribed” listing of trusted websites that they have personally reviewed which reflect reliable and up to date medical information for their patients.

Health care providers are becoming dependent on the Internet for instant access to important medical resources. As the Brazilian periodical recognized, a fact of modern day health care is that patients often have their first “consultation” with “Doctor Google”. We need to focus efforts on how best to use the Internet to improve the quality of care for our patients and direct them to useful and reliable information amongst the millions of potential sites that may be available. The “Internet Prescription” is one small step to help patients who consult with “Doctor Google”.

Leonard G. Gomella

Thomas Jefferson University

Philadelphia, Pennsylvania


© The Canadian Journal of Urology™; 17(1); February 2010