Surfin’ the Net

I can’t tell you how many times I’ve had patients timidly admit that they’d researched some aspect of their medical condition online. That confession is usually followed by “You probably hate it when your patients get their information on the internet” spoken in the same tone of voice they use in their visits to the confessional.

I don’t really know where the perception comes from that doctors don’t want their patients researching their own health ailments on the computer. I, for one, am immensely relieved when I don’t have to educate patients about complicated conditions starting from square one—it’s nice when they have already looked into the basics of the disease and explored the possible treatment options even before they come to me for an opinion.

I think it’s fair to say that most patients and doctors find the internet a valuable source of medical information and are eager to make use of it. In that spirit I’d like to share with you my favorite web-based medical resources:

1. WebMD. I list this one first not because it’s my favorite but because it is so commonly referenced. I like the patient-based information that is available on a wide variety of subjects, but I don’t much care for the distracting gauntlet of advertisements and sponsored links you have to navigate to find your subject. Those of you who make use of my (sometimes overused) hyperlinks will note that I frequently cite WebMD for background information.
2. WrongDiagnosis. This site allows you to enter your symptoms and let the computer take a crack at the diagnosis. I have to admit this didn’t work so well for me. I tried to diagnose a heart attack by entering “chest pain, sweating, shortness of breath” and came up with 396 different possibilities (including “acute leukaemia of ambiguous lineage”). Still it’s good for providing you with a long and exhaustive list of possible ailments to account for any given symptom.
3. Centers for Disease Control. The CDC sponsors a great website that allows you to quickly find very reliable information about infectious diseases and public health concerns. Want to cut through the myths and half-truths about the H1N1 vaccine? It’s all there with extensive referencing. Need the final word on insect repellents? Rodent-borne diseases? Black mold? This is the place.
4. Merck Manual. I’ve long been a fan of the Merck Manual, the 110-year-old medical encyclopedia, now in its 18th edition, and have had a copy on my shelf ever since I started medical school. The Merck Manual site is a great resource if you need more information that you can find at places like WebMD. You can even download podcasts on a huge number of subjects, written and narrated by medical specialists.
5. UpToDate. For the medical professionals, this one is hard to beat. It is by far the most exhaustive and current resource of medical reviews available. The downside? It costs a fortune to subscribe. Since mortgaging my house to gain access to this valuable resource I’ve turned to it frequently to supplement my knowledge base. I recommend it only if you like to read a lot and have a rich uncle in poor health. UpToDate does offer a valuable trove of patient information that is free to the public.
6. Quackwatch. This is a wonderful non-profit site aimed at providing peer-reviewed scientific information to debunk unproven or ineffective alternative medicine remedies. I like it because I can quickly educate myself on various new products and therapies my patients ask me about. So, before you let grandma invest her life savings into that diet of blue-green algae she heard about on the shopping channel make sure she takes a look at this website.
7. theheart.org. This resource is most useful for cardiologists but also contains great information for all professionals. It summarizes and editorializes the latest breakthroughs in my field with direct access to the experts on the front lines of research. It also offers an enormous library of professional slide presentations on every cardiac subject imaginable.
8. Medscape. This is a nice all-around site for both patients and providers that I’ve turned to for years for information on medications and as a search engine for the MEDLINE database. It’s also a great resource for online continuing medical education.
9. Wikipedia. Okay, I’ll admit it—this is my guilty pleasure. I love turning to Wikipedia for medical information, especially when I need only a superficial but broad perspective. It’s also a great resource for information relating to the history of medicine.
10. CHI Cardiology Blog. A valuable source of dubious wisdom, questionable medical punditry, and sorry attempts at humor. I turn to it at least weekly.

That’s my list. I’d love to hear from you. What do you think of the use of the internet as a resource for patients? What are your most trusted sites? The comment button (below) is so rarely used it has collected web dust. Give it a try and let us know what you think.