December 1999 Bulletin

Help patient filter Internet information

Government, educational web sites are most accurate

By Sandra Lee Breisch

The Internet has grabbed people's attention and they don't even question what's on it.

"It's really an unrefereed maelstrom out there," says Jill M. Shuman, project director of the Center on Nutrition Communication, Tufts University School of Nutrition Science and Policy. The school developed Nutrition Navigator,, a web site that quarterly reviews various nutrition web sites using a 25-point rating system for evaluating the accuracy of information. Shuman says Tuft's "university partnerships" with web site providers is productive in improving quality consumer health information on the Internet.

Take the web surfing patient who walks into your office demanding a specific medication for osteoporosis.

"The orthopaedist who has been treating this patient for many years and knows other conditions could preclude him or her from prescribing it might say, 'this medication just might not work for you,'" says Shuman. "The Internet is never going to replace personal contact and a physician's intimate knowledge."

But if you want to help your patients filter out medical misinformation found on web sites, here's some advice provided by Shuman:

Inform your patients to surf for medical advice on web sites produced by a society or medical association affiliated with orthoapedists such as the

What's the difference between the reliability of medical information found on web sites vs. flyers, magazines or textbooks?

"On web sites you don't always have an entity to go back to," reminds Shuman. "In print, your patients usually have a concrete entity to go back to such as the author, particularly if medical advice is found in a health magazine or medical text book," says Shuman. "A lot of magazines and books are reviewed by medical advisory boards. They're going to be leery of printing something that is not credible."

Shuman also suggests that if a patient reads a medical textbook on his or her condition and learns of a number of treatment scenarios, the physician should tell them "each patient is unique and what works for one patient will not work for another."

However, orthopaedists should not frown on the "educated consumer" who walks into the office. "They should view the information patients receive as an aid-rather than a danger," says Mary Jo Deering, PhD, director of Health Communication and Telehealth, U.S. Department of Health and Human Services. Their office manages, now serving 400,000 users a month. "The federal government prefers to look at it [getting medical information on the Internet] as a glass full-rather than a glass half empty," she says.

"Health care providers, either individually or in a group practice, should adopt a policy towards medical information," says Deering. "Broadly speaking, the policy would sort out what reputable sources are available. But I would always have them refer patients to federal sites."

Deering suggests physicians give patients handout sheets with reputable medical sites listed and instructions on how to surf the Internet.

And physicians also should strengthen their own use of Internet activity. Physician practices should have their own web sites with links to government and/or other professional academic sites and direct their patients to visit those.

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