Medicine and the Promise of the Internet

Author: 
David A. Westbrock, MD, FACP, FACE
Article Type: 
Commentary
Issue: 
Summer 2001
Volume Number: 
6
Issue Number: 
2

Nothing is so invigorating to the American consciousness as freedom. It is the lifeblood of our nation, as in Lincoln's Gettysburg Address --- "conceived in liberty and dedicated to the proposition that all men are created equal." It is of great importance, then, that the public pay close attention to how they handle the promise of the Internet, the engine that is driving our long economic boom. Given the great potential for bringing the world's neighbors in closer proximity, it will be of great interest to see how our government deals with the great promise it represents to deliver improved standards of living and of health to princes and paupers, rich and poor, famous and common, alike.

It is limitless with regard to providing information on any subject one can imagine. In terms of our political system, it provides an outlet to the reporter, who may not be able to get the message out through the usual biased media channels. At the same time it allows access to information that may not be otherwise available through those same conventional and often closed sources. From recipes to how to build a nuclear reactor, we have more than entered, we have become immersed in, the information age.

Now comes the Internet to the world of health care. It is certain that a wider audience than ever is now tuning in to the worldwide web to get information on everything from ginkgo to toe fungus. It is altogether fitting that the Internet is an American institution, born of our very special inventive traits. uniquely our own. In the U.S., however, the wide dissemination of medical information, although subject to error, outdated or incomplete data, has the potential to increase the health of our citizens by providing inexpensive and easily accessible preventive health knowledge. There are many content sites to find a doctor, describe Aunt Tilly's personality change, discover the latest treatment for macular degeneration or hair loss. There is even a site one can go to find the average cost of any procedure done in any doctor's office or hospital (despite the American Medical Association's legal action to stop it). Dispensing care, then, where practical and appropriate and ethical can potentially correct one great curse that confronts our system today. Most patients are not able to receive the kind of care once taken for granted, from whom and when they want it. Further, doctors are no longer able to practice the care they learned in training and from experience, unfettered by an insurance clerk or a government bureaucrat.

For many services that do not involve "hands on" by a physician or performance of a procedure, a simple cyberspace transaction can be made directly between doctor and patient. Eventually, with the evolution of technology, long distance diagnosis and evaluation will become a reality. This will inevitably empower patients to take responsibility, both in choosing who provides that care and how much. Because of market driven reductions in costs, they will realistically bear the financial burden to be able to make free choices, without permission either from Uncle Sam, "the Blues" (Blue Cross-Blue Shield), or other third-party insurance carriers.

The socialization of health care, an inevitable result of our current entitlement culture, brought about by the overreaching of politicians in expanding Medicare and indiscriminate programs such as government-funded health insurance to children (SCHIP), represents a snow ball rolling down hill. Socialism is a European invention, brought to the U.S. more than 50 years ago. Free enterprise was made in America, which has enabled the best health care system in history. It may yet be saved by another...the Internet.

Dr. Westbrock is a endocrinologist in Dayton, Ohio. His e-mail is dwesty@worldnet.att.net.

Originally published in the Medical Sentinel 2001;6(2):65-66. Copyright©2001, Association of American Physicians and Surgeons (AAPS).

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Comments on this post

Is the Internet so promising?

Although the internet may provide “limitless” information on any subject, it is very limited with regard to the quality of the information provided. The Net is a phenomenon that could only have arisen in a society that has come to value quantity over quality. The end result of any process that makes any one thing as good as any other without adhering to a hierarchy of values is that the lowest common denominator determines what is abundant. At one time publishing a book was difficult because those who controlled the publishing process adhered to high literary standards. This ensured that the books published were of high literary quality. They were read by a relatively small and highly educated section of the population but then this was the section of the population whose cultural output was not only abundant but valuable. The same could be said for the process that determined which works of art and music “made it” into general circulation. Any attempt at mass production (and what is the Internet if not mass production of information on a grand scale) depends for its success on creating a public taste for that which is simplest, basest, and most elementary. In turn, the production of literature, art, music, or "information" that appeals to a more discerning taste becomes harder and harder for the simple reason that it is not popular with the masses and is therefore not profitable. Although the profit motive for putting valuable information on the Net may be less strong, the sheer volume of useless information makes the more valuable information difficult to find. Anyone can create web pages, post replies to articles, and write so-called “blogs” (somehow the ugliness of that word suits the situation perfectly). However, this accessibility has only ensured that the Net is filled with contributions from people who have no business being heard by the public because they either have nothing of value to say or because they do not have the command of language necessary to make a worthy point. Dr. Faria’s site is a refreshing exception but in my own case one found through a lucky accident.

The value of medical information posted on the Internet is generally inferior to that which could be obtained by having a conversation with one’s doctor. One’s own physician, provided he is a competent fellow as a result of having passed through a highly selective (not easily accessible) training process, can provide not only general medical information but most importantly the kind of information that takes into account the patient’s unique circumstances. Computerization of the medical record has so far produced at best equivocal results. The electronic medical record is most useful neither for providing nor for receiving medical care but for generating reports used by bureaucrats to “administrate” the health care scene. Anyone who has seen EMR reports of ER visits, hospital discharge summaries, and consultation records will attest to the frustration of sifting though pages of useless and distracting information, the legible gibberish of automatic transcription software, and to the kind of paper waste that would never have occurred when paper records were being used. We are living in the “age of information”. Perhaps more of us should think not only about how much information lies at our fingertips but about whether this information is any good.

Insightful

Momentous and marvelous comment in both originality of thought and information value. It evinces another side to mass information that the intelligentsia, as individual opinion molders, has avoided to discuss, afraid of being labelled elitist.

You write: "...the sheer volume of useless information makes the more valuable information difficult to find. Anyone can create web pages, post replies to articles, and write so-called “blogs” (somehow the ugliness of that word suits the situation perfectly). However, this accessibility has only ensured that the Net is filled with contributions from people who have no business being heard by the public because they either have nothing of value to say or because they do not have the command of language necessary to make a worthy point."

How politically incorrect but true! In our egalitarian society today everyone has to have an opinion, as devoid of substance and as empty as it may be! The problem is most people are not reading or becoming informed because their uninformed opinion is just as worthy!

Nevertheless, overall I do think the net effect of the internet (and mass communication and information) has been beneficial in providing additional health information to the better informed public in particular. It has also been salutary in espousing contrary points of view to those offered by the opinion cartel of the mainstream media and in preserving freedom of speech in politics in general.

As to the rims of useless gibberish, paper, and bureaucracy in the Age of Information, it is indeed a disgraceful, wasteful and worsening scenario. But I believe it is more related to the growth of government and red tape in both the public and private (following the lead of the government) sector than the advent of the internet.

As to: "...Dr. Faria’s site is a refreshing exception but in my own case one found through a lucky accident." Thank you!

As usual an insightful comment that inspires thought. Welcomed back Orval Tisbe!

Medicine the Promise

Interesting article about the internet and the socialization of medicine. It gives an idea of the direction health care is taking today (e.g., Obamacare), even though the piece is several years old.

Thank you for keeping this piece on the web.


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