|National Public Radio (NPR)
December 13, 2007 Thursday
SHOW: Talk of the Nation 2:00 PM EST
Do-It-Yourself Diagnosis on the Web
ANCHORS: NEAL CONAN
NEAL CONAN, host:
This is TALK OF THE NATION. I'm Neal Conan in Washington.
On a typical day, about eight million of us type back pain, migraine
or some other medical condition into a search engine. More and more,
the Web is our first stop for health-related information. Some
people self-diagnose and try to treat their own problem, some scare
themselves silly, a lot more research their complaints so they can
go to their doctor with the right terminology and the right
questions. Those same search engines can also uncover a lot of
information about that doctor, everything from where they went to
medical school to their home address. Whether you're a doctor, a
patient or both, how do you use the Internet?
Later in the hour, "Ask Amy" of Amy Dickinson's - let me try that
again - Amy Dickinson of "Ask Amy" joins us to talk about that
moment when we all just want to get away.
But first, Google M.D. Do you use the Web to investigate your
symptoms? How does it change the doctor-patient relationship? Our
number is 800-989-8255. E- mail us, email@example.com You can also join
the conversation on our blog at npr.org/blogofthenation.
We begin with Dr. Scott Haig. He's an orthopedic surgeon and a
contributor to TIME.com. Last month, he wrote about an over-informed
patient for the Web site. He joins us from his office in Westchester
County, New York. And it's nice to have you on TALK OF THE NATION
Dr. SCOTT HAIG (Orthopedic Surgeon; Professor, Columbia University):
How are you, Neal?
CONAN: I'm well. Let me ask you about this woman you call Susan(ph).
You also call her a brain sucker. What's a brain sucker?
Dr. HAIG: Well, if you're a doctor and you answer people's questions
all day long, there are certain people that you get the impression
are not just after the information and the questions. They want you
to say it a couple of times they want you to tell them something
that they themselves want to hear they may know already. That's a
brain sucker, and it's like anything else. If you experience one,
you absolutely know what it is.
CONAN: One of the symptoms of a brain sucker, you say, is when they
call you up, you can hear them quietly typing into their search
engine as you're speaking with them.
Dr. HAIG: Well, this lady that we wrote the article for TIME.com,
she actually called me. She got through to me through my office
staff and while she was talking to me, I could hear her clicking in
the background. And I had the feeling immediately that this lady was
actually looking me up or looking at the computer about me while she
was talking to me.
CONAN: And it turned out when she came in, she knew an awful lot
Dr. HAIG: Yes, she certainly did.
CONAN: And you found this a little, you know, of course, people are
going to look up the information about their doctor, but there's a
point at which it becomes creepy.
Dr. HAIG: Well, it was all creepy with her because she knew where I
lived. And, you know, it's not that hard to find out a lot of
personal information about people if you're a good Googler(ph) and
you know, the Web search, with a few clicks, you could find out a
lot of things, and it's difficult for professionals oftentimes to
keep distance from our patients. When they have this much more
ability to get in there and not just find out about their sickness
but about you, it's a problem.
They - people should be able to look and find out things about their
doctors. You want to know, you know, if this guy has trained
properly, if this - he has any standing in the community. But where
the cutoff line is, you know, where he goes, where his kids go to
school, that sort of thing, that's a problem.
CONAN: Or - but if he has got his medical degree from the University
of Bora Bora(ph), that might be interesting.
Dr. HAIG: Yeah. Now, people should find that sort of thing out I
think it's only helpful.
CONAN: There is also a moment at which you said you were ready to
punt and she knew it. What were you talking about there?
Dr. HAIG: Well, this was a patient who had been to three other
doctors just like me before coming to see me. She had a problem that
was not easy to fix no matter how you do it. And I knew that she
knew I was not going to go all the way with her, you know, we just
didn't click and I wasn't going to put up with this kind of patient.
And as it tuned out, the reason I wrote the article was the person I
suggested she go see instead of me, who was somewhat may be more
focused on her particular problem, she already had an appointment
with the man...
(Soundbite of laughter)
Dr. HAIG: ...a couple of days after mine, so I didn't really feel
like I lost anything to that patient.
CONAN: And let me ask you, you do also characterize patients in a
number of different categories and you say nurses, people who know a
lot of the information already, that they're your favorites.
Dr. HAIG: Yeah. In that article, I said that nurses are my favorite
patients because they tend to have respect for doctors and that's
not a common thing in the lay population, at least in the northeast
right now. Underlying the whole Googler problem with the fact that
people just don't tend to treat each other with the proper amount of
respect, doctor respect has been overdone in the past probably. But
this day and age, a lot of us are feeling a real lack of respect.
Nurses who rely on doctors for their orders and who work with
doctors every day tend to give us more respect. They know the words,
they know the anatomy, and I find them to be really great patients;
I have a lot of nurses in my practice.
CONAN: We're talking with Dr. Scott Haig, who wrote an article for
TIME.com about a - well, incredibly well-informed patient. If you'd
like to join the conversation about Google M.D., our number is
800-989-8255. E-mail us firstname.lastname@example.org
And let's start with Katie(ph). Katie with us from Grand Rapids in
KATIE (Caller): Hi. I had my first baby a couple of years ago and I
did a lot of research on the Internet about everything from labor
and delivery to pregnancy. And before I actually talked to my
personal O.B. about this - my questions, I would call this friend of
mine who's an OB/GYN, and he finally said, Kate, get off the
computer. You are getting just enough information to think that you
know what you are talking about when the fact is a lot of the stuff
that you're reading isn't necessarily good medical information. And
I wondered if there's a paranoia that seems to come along with all
this information or is it something just particular to pregnancy?
Dr. HAIG: That's a great question, great comment, Kate. The problem
is that when the lay public who hasn't trained - they don't have any
real idea of what's common, what's not common, what happens, what
doesn't happen - when you get exposed to all of the possibilities,
you can make yourself crazy.
Dr. HAIG: We see this oftentimes with prescribing drugs, you know -
a very commonly prescribed anti-inflammatory drug. If people get
that package insert and they read it, they can be paralyzed with
fear when they're taking - what they're taking is an aspirin. And if,
for instance, there were a package insert that came with something
like aspirin, say, real regular aspirin, people wouldn't take it
because the number of things that have to be listed because of
various medical FDA rules, et cetera, are so many. So there is a
kind of a person who actually has done a favor by pulling the plug
out of the wall on the computer sometimes in medicine.
CONAN: Katie, how was the baby doing?
KATIE: Oh, wonderfully.
CONAN: Uh-huh. And do you still go online to look at skin knees(ph)
and that sort of thing?
KATIE: I've tempered it a little bit. Now, when I look, I put it
through a little bit of a filter considering the stories in that,
you know, talking to somebody who has actual medical experience
might be more useful to me.
CONAN: Okay, Katie. Thanks very much for the call.
KATIE: Thank you.
CONAN: Bye-bye. And Dr. Haig, I wanted to conclude by asking you
what's been the response to that piece?
Dr. HAIG: Well, this particular article was fairly popular, it's
still shooting around, you know. At the TIME.com Web site, there's
always a list of who's getting looked at, clicked and e-mailed the
most and it was up there for quite a while. There are a few blogs
that I've been watching that had been talking nicely - some not so
nicely - about the whole idea of should patients have any kind of
responsibility in the doctor-patient relationship. And I am writing
another article, I'm sort of chairing a roundtable discussion of
this for one of our journals called Orthopedic Review.
CONAN: I'll look for that in our mailbox.
Dr. HAIG: I'll try to give it to you.
CONAN: Thanks. Dr. Haig, thanks for your time today.
Dr. HAIG: My pleasure. Take care, Neal.
CONAN: Scott Haig, an orthopedic surgeon and contributor to TIME.com.
He joined us from his office in Westchester County in New York.
Joining us now is Susannah Fox, associate director at the Pew
Internet & American Life Project in Washington, D.C. She's been kind
enough to join us here today in Studio 3. Nice to have you on the
Ms. SUSANNAH FOX (Associate Director, Pew Internet & American Life
Project): Thank you.
CONAN: And you conducted a Pew study on people that go online for
medical searches. Is this more common today that patients go online
before they go to the doctor's office?
Ms. FOX: Yes. We find that most people these days are preparing for
doctor's appointment and recovering from the doctor's appointment by
going online. Eighty percent of Internet users have looked for
health information online.
CONAN: I was interested looking at the survey. Most of them seemed
to go online to look for information on behalf of somebody else.
Ms. FOX: That's right. Half of searches are on behalf of someone
else. And that's interesting because they are maybe caring for
someone who isn't able to go online, maybe it's an elderly person,
or it's someone who's frightened and doesn't want to see what's
available about what's going on with them.
CONAN: Are you sure it's not just I was asking for a friend?
Ms. FOX: It could be. It also could be that it's important to
remember that when someone who's diagnosed or someone who's sick,
it's not just the one person, it's the whole community of people who
care about them who want to find out about that condition, what's
going on in their friend's life.
CONAN: And, interestingly, do people go on to look for specific
information about a condition or to find - what kind of information
people are looking for?
Ms. FOX: We ask about a whole range of topics. The most popular is a
specific medical condition or a procedure. And that's when we know
that it's probably in reaction to, you know, news from the medical
professional. But we also ask about a broader range of topics, like
alternative therapies, diet, fitness and nutrition, mental health
information, other things that may or may not need a conversation
with a doctor.
CONAN: And this information is also, you find, influential.
Ms. FOX: It is. People say that it has an impact on their decisions
about how they care for themselves or care for someone else. It has
an impact on their treatment decisions that they often make in
consultation with a doctor.
CONAN: And the one caveat you seemed to come up with - there were a
couple of them - people don't tend to look at when this information
was added to the World Wide Web or necessarily the source of the
Ms. FOX: That's right. Three quarters of E-patients - that is
Internet users who find health information online - three quarters
do not check the source and date of the information. Those are the
two of the most important quality indicators, and that's from the
Medical Library Association. And most people are not looking
probably because it's not available. The Department of Health and
Human Services did a study and found that only about 4 percent of
popular Web sites, popular health Web sites, actually disclose that
Ms. FOX: Yeah.
CONAN: And there's also a lot of - you know, a lot of these Web
sites are free.
Ms. FOX: Absolutely. They are free, and actually a lot of the
general search engines create an algorithm that privileges the
dot-gov information or the dot- edu information. And by that, I
mean, approved by the federal government or approved by an
CONAN: So it won't necessarily go to those. It will go to the
Ms. FOX: Well, basically, if you search just a general search on
Google or Yahoo or MSN, it often comes up that there is a dot-gov
source at the top, which is why a lot of people learn that this is
CONAN: We're going to continue this conversation in just a minute.
If you'd like to join us, give us a call, 800-989-8255. E-mail:
email@example.com How do you use the Internet in terms of your questions
I'm Neal Conan. Stay with us. It's the TALK OF THE NATION from NPR
(Soundbite of music)
CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington.
When you're sick, well, you usually call your mother then maybe you
call the doctor. But the first stop for a lot of people these days
is the Web, which has its advantages and its downside. That's our
focus today. Do you use the Web to investigate your symptoms? How
does it change the doctor-patient relationship? 800-989-8255. E-mail
us, firstname.lastname@example.org You can also send us comments on our blog at
In a moment we'll hear from a doctor who advises all of his patients
to Google their health. But let's continue now with Susannah Fox,
associate director at the Pew Internet & American Life Project. And
Susannah, I wanted to ask you there are many millions of people in
this country without health insurance. Are they using the Web in
part because of that condition?
Ms. FOX: You know, that's something that we suspected but found in
our surveys is not true. That we do not find that people without
health insurance are any more or less likely to go online to gather
health information. It actually is more broken down along age lines.
People in their 30s and 40s, baby boomers, are very likely to be
using the Internet to get a second opinion.
CONAN: And I was just going to ask you about the demographics.
Thirties and 40s and baby boomers - who, obviously, a little bit
older than that these days - these are better well-to-do people,
presumably people with good computer access.
Ms. FOX: Yes. What we do find is that people with a college
education, first of all, are likely to have Internet access and also
people on that middle-age range are wired, both at home and at work.
And we've now reached 50 percent of homes in the U.S. with
broadband. And broadband really changes you as an Internet user. The
Internet becomes the go-to source for all kinds of information
CONAN: There are, of course, a lot of other sources of information
about health. Do people use those as well?
Ms. FOX: Yes. There are surveys that are done by the National Cancer
Institute that actually asks people about all the different media
offline and online sources. And it is still a mixture of media.
CONAN: Susannah Fox, thanks very much for being with us today.
Ms. FOX: Thank you.
CONAN: Susannah Fox is the associate director at the Pew Internet &
American Life Project here in Washington, D.C., and was kind enough
to join us today here in Studio 3A.
Also with us is Ted Eytan. He's the medical director of Health
Informatics and Web Services for Group Health Cooperative, a
nonprofit health care system. And he's with us here in Studio 3A.
Thanks very much for coming in.
Dr. TED EYTAN (Medical Director, Health Informatics and Web
Services, Group Health Cooperative): Good afternoon.
CONAN: And how do you think this use of the Web that we've just
heard about changes the doctor-patient relationship?
Dr. EYTAN: Well, I think the thing that we have to do to react is to
innervate around it and accept that this is what our patients do. So
Group Health Cooperative supports about 580,000 members in
Washington State. And what we do is we find out where our patients
are and how we can support them. The reality is they're going to do
this. We focus-group tested them and even though we have a
comprehensive Web site and allowed them to e-mail us and check their
medical records online, a lot of times what they do at the
information we give them online securely is go to Google and check
Dr. EYTAN: And if they're going to do that, then let's support them
in doing it because, really, information is therapeutic. And the
more information people have that's accurate, the better. And really
what people want is information from their doctor that's trusted in
addition to the online sources. And I think sometimes the medical
profession shies away from being online with them which causes this
CONAN: Well, we'll talk about that reluctant to the profession just
a minute. But it seems to me what you're saying is that Google M.D.
is the second opinion.
Dr. EYTAN: Well, if that's where people feel comfortable getting
information, they're welcome to do it and they can check it out with
us, and we're here to help them. I mean, the issue about respect is
the person paying the bills is the patient. And so the respect
belongs to the patient. And they will respect us if we respect them.
CONAN: Is this - in general, you're saying, well, we have to live
with it. Would you consider this a positive step?
Dr. EYTAN: Generally, yes. I think it's causing us to react to
innervate, to provide care the way patients want it. I mean, no
patient has ever said I prefer to get care only from you in person.
You know, people want to get care at all times of the day, all times
of the week. And now, we can offer it that way. And because of this,
we know can access (unintelligible) physicians through e-mail,
24-by-7 toll-free Nurseline. That's what people want.
CONAN: But some people go on the Web and diagnose themselves, and
well, sometimes they get it wrong. Have you gotten calls from people
who say, doctor, I think I've got the yaws?
Dr. EYTAN: Sure. I mean, I have patients that come in and say, well,
I looked at (unintelligible) at Healthwise Knowledgebase. I looked
at that, and here's what I think I have. And I use that as a
starting point. I say, great, I'm so happy that you're empowered
around your health. Let's see if that's really what you have.
CONAN: Okay. Let's see if we can get some more listeners involved in
the conversation. And let's go to Kara(ph), Kara with us from Bend,
KARA (Caller): Hi...
KARA: ...and how are you?
CONAN: I'm well. Thanks.
KARA: Good. I don't know if this counts as public speaking, but it
makes me nervous. So I'm just trying to make my point the best I
CONAN: Go ahead, please. It's not so hard.
KARA: Okay, thanks. I work as a massage therapist in Bend. I work
with chiropractors, acupuncturist, and out of doctors offices. And
whereas, I have a great respect for doctors, I don't always have a
lot of faith in them being able to diagnose musculoskeletal issues.
I've got some good examples. You know, I've seen a woman who was
complaining with chronic headaches. The first thing her doctor did
for her was give her Botox injections in the back of her skull. I've
seen people who have gone to their doctors with back problems who's
been given prescriptions or even had their nerve cauterized before
they've ever seen a chiropractor done massage, done acupuncture or
any kind of alternative treatment.
I also have a good relationship right now with a man who specializes
- his practice is in arthritis. And he says he's office is
constantly filled up by people that have been sent to him from the
regular M.D. telling them, which I believe, is already detrimental
to their, you know, mental well-being that they most likely have
arthritis. And he said they come to him with just, again, simple,
you know, muscle issues that massage or a chiropractor could help.
I think that it is a really good thing when it comes to - especially
when it comes to somebody that could head into surgery or
alternative care for them to have the Internet at their fingertips.
I mean, that way they're able to look and see, well, my doctor is
saying this but other people are saying all these other things, and
that might not be information that they're otherwise able to find.
And in some cases, it might actually save somebody from rushing into
surgery that is unnecessary.
CONAN: Kara, you might want to consider public speaking. You're not
(Soundbite of laughter)
KARA: Thank you.
CONAN: Ted, what do you think of what Kara had said?
Dr. EYTAN: I think it's a great point. You know, I'm a family
physician and they say the best family physicians know what they
don't know. And it's clear that there are things that patients bring
to us that we don't know the answer to. And I ask patients how do
you feel about the fact that if I don't know something, I may look
it up in front of you. And in fact, they say that makes me more
comfortable, more confident in you. And our health care system
covers alternative care, a trainer at medical school that taught us
about it. And so it's silly for us not to bring all those extra
There's data that shows the average physician interrupts a patient
23 seconds after they start telling their story, and a patient
that's allowed to tell the story can do it in six more seconds. So
why don't we just give them the six more seconds and then bring in
all the extra information.
CONAN: Yeah. Thanks very much for the call, Kara. But I wanted to
ask you, Ted, is a lot of this affected by the fact that doctor's
appointments these days tend to be so short. If you've got 15
minutes, you might want to come in as opposed to, you know, starting
from zero saying, well, here's what I think is going on.
Dr. EYTAN: Well, in fact what we have done now that we have e-mail
access to all of our 900 physicians in our care system is realizing
health care is not about the visit. So the purpose of health care is
to allow patients to achieve their life goals. It's not to get
health care. And so the visit for us becomes a starting point. Our
visits are 20 minutes long. So number one: We need to listen longer
than 23 seconds. And number two: We continue the relationship
outside of the visit. And so often for me, I continue the
conversation via secure e-mail three and four days after. As
whatever it is unfolds, they can come back if they need to, but
often they don't need to. But - and that extra three to four e-mails
makes a huge difference.
CONAN: Another caller. This is Kelly(ph), Kelly with us from Norman,
Oklahoma. Kelly, are you there? And I think Kelly has hung up on us
or maybe being in Norman, Oklahoma, the ice tree brought down its
power line there or phone line.
Let's go to Rob(ph), Rob with us from - where are you, Rob?
ROB (Caller): I'm in Poquoson(ph) City, VA.
CONAN: Okay. Go ahead.
ROB: Hey, yeah, I'm a pharmacist and I think the Web can be good and
bad. I get a ton of people coming into me every day saying, you
know, I saw this on the Web, is this right for me? First of all, you
know, like they say a fool - they say, someone who's his attorney is
a fool for a client or whatever how it goes. I'm sorry, I'm a little
ROB: But I think the same thing could be the Web. I mean, you know,
it's great that you can look up stuff but you still should relate
that information to your health care giver because that could
interact with the medicine you're on or it may not be even
appropriate for you. So how people interpret that information is
CONAN: So get out of the cocoon, talk to people is what you're
ROB: Exactly. And, you know, I mean, 24/7 health care is great. But,
you know, you - people have to realize there are limitations to what
you can get in health care. You have to be your own patient advocate
and you have to really, you know, educate yourself, yes, but also
your doctor is there. This guy has experience. He is the one that
went to school. And yet, no doctor is perfect, but no one else is
either. You need to talk back and forth between your health care
CONAN: Interesting. Ted?
Dr. EYTAN: You know, I think that the doctor has school experience
but the patient has life experience. And so the thing that this is
doing, which is really wonderful and I'm not unique - I'm one of 900
physicians in Washington, 13,000 permanent physicians nationwide -
who - our role is changing in a good way. So we're becoming coaches
and teachers and we're taking a new information people have and
we're helping them judge what the quality of information is.
And sometimes, they bring us things we didn't know. And so I don't
what to have a prescribed way a patient is supposed to behave with
me because what am I missing. And there's - the health care history
is littered with things that we have done that have not been helpful
CONAN: But do you - and I wonder if this applies to you as well,
Rob, come into - you know, run into people who said, well, I need
250 milligram tablets of this particular drug that I would take four
times a day.
ROB: And I would say, well, why do you need to take that? What are
your signs and symptoms?
Dr. EYTAN: Exactly.
ROB: Is that really appropriate for you?
Dr. EYTAN: Exactly. Well, start with why. And if you listen for a
while, they'll say because I'm worried because of X. And that's the
thing that you can focus on.
CONAN: Yeah. Rob, thanks very much for the call. And...
ROB: Okay, no problem.
CONAN: ...fear plays a large part. People are frightened a lot of
the time of the implications of what they are feeling.
Dr. EYTAN: I agree. I mean, as I say, you know, if you walk into any
waiting room in any medical center, 10 percent of people are scared
to death because they have no idea what they have. And let's not
forget that. And so half of what we do is making people feel
reassured that they have access to the right information, that it's
comfortable for them and it's what they need. And when they leave
without that reassurance, it's just going to cost more and more of
CONAN: Let's go now to Paula(ph). Paula with us from Worcester,
PAULA (Caller): Yes. You know, I was calling in reference to the
access to the Internet playing a role for physicians providing good
care also because, for example, I'm a Parkinson's specialist and I
provide deep brain stimulator surgery and Botox and clinical trials
and that kind of thing.
But I actually Internet-access with our satellite facilities to
coordinate, you know, in rehabilitation services, psychological
support services, in nursing oversight and home education for
self-injection protocols, that kind of thing, and find that it's
hugely valuable, especially when you're in kind of a funneled system
where you're the only specialist around and you have a giant
catchment around you. You don't want to be, kind of, providing
substandard care of the community and then say, well, you know, if
there's a problem, we'll just send them to the university hospital
and then they're not our responsibility anymore.
I try to work through the satellite hospitals and community where
(unintelligible) specialists, especially the other neurologist, by
the doing the Internet services sending them, for example, you know,
Academy of Neurology algorithms for treatment and protocols for
titration of medications and communication access for lab results
and database, for example, on how patients' activities of daily
living are in reference to their current treatment guidelines.
Because a lot of times, even as a specialist, when I have many more
minutes to spend with each individual patient than somebody out in
the community, it's hard to get all the information you need. And
even worse if somebody is sent from a facility with, say, an aide
who had never worked with them before and has no clue what's going
CONAN: So it sounds - if I'm hearing you correctly, it sounds like
you recommend specific Web sites or places they should go for
PAULA: Right. And we've created our own, too. In fact, you know, one
of our new Web sites - and I'm going to be rolling out - aside from
providing a database that patients can log into to help us with
monitoring new treatment protocols is, you know, for new patients
coming in that before they come into their visit, they can answer a
whole series of questions on an Internet, you know, safeguarded,
hit-guarded(ph) Web site that allows them to do a history and kind
of review all their medication records and stuff like that so that
we don't have to spend that time in face-to-face office visits
addressing those issues, which can be done ahead of time.
CONAN: Ted Eytan, will the same principles apply for a family doctor
Dr. EYTAN: Group Health has been doing that for a year. We have an
online electronic Health Risk Appraisal. Kaiser Permanente has
launched My health manager. We want to embrace all this technology.
We want patients to be with us wherever they want to be rather than
we are. It's a better way to do health care. I think to the caller,
it's envisioning the health system where that specialty expertise is
accessible wherever the patients need it. It's much better.
PAULA: Exactly. And we're also doing telemedicine for stroke
intervention which is a similar model where you have the specialist
at the university hospital, you have the video monitoring in the
emergency rooms and the community hospitals all over the country
that are contracting with us. And we're providing those, you know,
one-on-one services via the Internet, including MRN imaging, Acute
CT, transport, you know, instructions, et cetera.
CONAN: Well, Paula, thanks very much for the call.
PAULA: Thank you.
CONAN: We're talking today about Google M.D. You're listening to
TALK OF THE NATION from NPR News.
Let me just re-identify our guest, Dr. Ted Eytan, and he is medical
director of Health Informatics - that's a new word for me - and Web
Services for Group Health Cooperative, a nonprofit health care
system. And he is with us here in Studio 3A.
Let's see if we can get another caller on the line. And this is
Fernanda(ph). Fernanda with us from San Francisco.
Hello? Hello, Fernanda?
FERNANDA (Caller): Hello.
CONAN: Hi. You're on the air. Hello? I didn't know there was an ice
storm in San Francisco, too. Let's see if we can go now to another
caller. And this is Rose(ph). And Rose is in San Carlos, California.
ROSE (Caller): Hi.
ROSE: I'm on my cell phone so I hope the connection is okay.
CONAN: I hope so.
ROSE: I was a social worker in health care for many years and I just
had a couple of ideas. Knowing that patients are often going to be
coming to the doctor's office using the Internet which I think
everyone's agreeing is a blessing and a curse. I think it would
really behoove - and this is kind of piggyback from the previous
caller - doctors' offices to have some sheets prepared that they can
give patients that refer them to really credible Web sites, you
know? Because you type in something and, you know, you get 40,000
hits and, you know, a patient doesn't even know where to go and
what's credible. They kind of get lost in this maze of information.
They don't quite fully know how to interpret. I think...
CONAN: Yeah. The new study we were talking about earlier showed a
lot of people who are both confused and overwhelmed, not a majority
but a lot of people, nevertheless.
ROSE: Absolutely. And I think that when you go into the doctor's
office, doctors knowing that many patients are going to be using the
Internet should have - you know, granted it would be hard or easier
for specialist than generalist, but to have sheets saying, now, here
are like the six named Web sites to go to. That would be one idea
that I think should be - some of the doctors just kind of get on
And the other thing is that, you know, the patient information that
sort of form you fill out when you're a new patient when you go to
the doctor that it might be helpful to include some questions on
there about, you know, how do you get your health information other
than from your doctor. And that could be really important point of
discussion between the patient and the doctor. If a patient says,
you know, oh, from my friends, oh, I got in the Internet a lot or,
you know, whatever. That that could be addressed and you could
really help focus that patient kind of away from maybe, you know,
quote, unquote, "services and information" that might not be really
reliable and help really focus them in a good way on how to get
information other than from the doctor.
ROSE: So those were just my comments.
CONAN: Rose, thanks very much.
ROSE: You're welcome.
CONAN: One of the - I just wanted to ask you about that. Is - as you
refer people to other Web sites, to some degree, you're lending
credibility. Would you rather send them to something that you're
much more confident in? I mean, there's all kinds of Web sites out
Dr. EYTAN: Sure. Well, two things. I think you're now seeing this
second half part of the conversation, there is this wave of
innovative practitioners who are embracing this technology and
thinking about how they can help patients, which is great. Number
two, we do both. So we do have after-visit summaries that are
printed that refer patients to our health encyclopedia, Healthwise
Knowledgebase. And I ask them to look at that but also e-mail us
with any questions.
So we don't say what - where you should go, where you shouldn't go.
But we say where do you want to get information. The thing I'd also
add is that I've said since I've been practicing using our new
system that do access the Internet. It's like the sixth vital sign.
CONAN: Hmm. Okay. The sixth vital sign, that's interesting. Ted
Eytan, thanks very much for being with us.
Dr. Eytan is medical director of Health Informatics and Web Services
for Group Health Cooperative, nonprofit health care system based in
Seattle. He was joining us here in Studio 3A.
Coming up, our every other Thursday visit with "Ask Amy's" Amy
Dickinson. We'll get her take on the back from the dead kayaker who
turned up in London, and those moments when all of us just might
want to run away and disappear.
Stay with us. It's the TALK OF THE NATION from NPR News.