Internet not the best source for a second opinion

Your head aches and there's a crick in your neck that just won't go away. Is it the result of a stressful day at the office followed by a workout that was more intense than wise?

Or is it meningitis?

If you are like many with access to a computer, you begin typing away to get answers. Are your symptoms harmless vestiges of life in the fast lane or something infinitely more serious?
With increasing numbers of patients taking Internet information with them to their medical appointments, physicians are weighing in on the good, the bad and, sometimes, the blatant bunk they encounter.

"I've spoken with two families just this morning about that," said Dr. J.R. Bockoven, a pediatric cardiologist and director of outreach and education for the heart center at Akron Children's Hospital in Akron, Ohio. "Multiple times a day, I ask my patients to use me as a filter for what they learn on the Internet. Especially for pediatric heart disease. The story you might hear on the Internet might have nothing to do with your child's specific case.

CAUSING FEAR

"We take care of kids with holes in the heart, small and large. And other problems associated with other conditions. I tell families they may read about a story with a baby with a big hole with multiple problems their child might not have."

Especially when the health of their child is in question, parents inevitably go to the Internet, Bockoven acknowledged.

He cited a recent office visit with a 6-year-old patient with complex heart disease and a history of multiple surgeries. Results from an EKG revealed new findings.

"His mom's pretty medically savvy at this point. She's been in the hospital system enough but when you tell something to a family in the office, they go home, digest it and then reconstruct it and they have questions. People don't want to bother the doctor so they go to the Internet. Luckily, she called after that and had some questions and I was able to put it into perspective with her young man," Bockoven said.

CHECK THE SOURCE

He encourages informed use of the Internet, Bockoven added, suggesting that users search for sources written by specialists connected with medical centers.

"In the end, the crux of the whole matter is to use us as filters," he concluded. "The physician taking care of the patient is the one who knows most about him. And it behooves the physician to be that involved."

For urological surgeon David D. Heiser at Mercy Medical Center in Canton, Ohio, patients surfing the Internet are a given.

"Often they have a list of diagnoses prior to coming to the office," Heiser explained. "And I see it as a positive because patients often get worried because they think they have something worse. It prompts them to go to the office to have those concerns explored. They often are mistaken but usually are close to being in line with the diagnosis."

As long as the surfing sleuths stick with reputable sites such as WebMD, Heiser said, the education obtained only can enhance the doctor-patient relationship.

"I encourage them to bring in their findings and discuss those with their doctor. If it gets people concerned about health care and gets them in the door to discuss those issues, it is a good thing," he said.

At Premier Health Associates in Alliance Ohio, Dr. Debra Lehrer, who practices internal medicine, said she is concerned that patients give too much weight to information from questionable Web sites.

FOLLOW THE MONEY

"There is an incredible amount of a money that goes into advertising and it is done for a reason, because it is very effective. When my patients see a new product on television or in a magazine or on the Internet, it follows that I get lots of requests and many times they bring in clippings," Lehrer commented. "Sometimes it is appropriate, sometimes it is not appropriate." But, because she encourages her patients to take an active interest in their health, she sees every question as an opportunity to open a dialogue.

"Many of the Web sites have anecdotal stories and unsubstantiated reports with ridiculous claims that are not based on any evidence-based medicine or associated with any medical group," she said. "They may be totally off base but there is always a point of education to discuss. In my practice, I like to put a positive spin on things. Even though the initial information they bring may be bad, I hope my patients can leave with little nuggets of information that will help them take better care of their bodies and health."