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  • Second E-pinion

    More patients and doctors are turning to the Internet for a second opinion
  • Patients are increasingly turning for a second opinion not to another doctor, but to the Internet.
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    • Medicine and the Internet
      What role can the Internet play in the delivery of health care services?
      Professor Charles Jaeger and 17 students in the Southern Oregon University School of Business explored this question this...
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      Medicine and the Internet
      What role can the Internet play in the delivery of health care services?

      Professor Charles Jaeger and 17 students in the Southern Oregon University School of Business explored this question this winter in a for-credit course called "Medicine and the Internet."

      "Medicine and the Internet have arrived at a critical time in U.S. history. Important decisions are being made about how to make the delivery of health care services less costly, more efficient and more effective," Jaeger says.

      The federal government has already invested half a billion dollars in creating an online medical-records database and hopes health care providers will one day use it to access the records of out-of-town patients, write electronic prescriptions and increase the efficiency — and thus decrease the cost — of health care.

      Will privacy be the loser in this probable future? Which stakeholders will benefit? SOU plans to offer the class again later this year.

      For more information, contact Jaeger at 541-552-6714
  • Patients are increasingly turning for a second opinion not to another doctor, but to the Internet.
    The rate of new medical discoveries is increasing so rapidly that doctors, especially general practitioners, simply do not have the time to stay on top of it all. Much of this information is available with little more than a Google search.
    When Judith Ticehurst was diagnosed with diverticulitis, she wasn't ready to accept that a severely restricted diet, based on decades-old information, was the only solution.
    "My doctor handed me a flier ... but it was so generic and dismissive. I thought that there's probably more current information on the Internet," says Ticehurst, a Medford resident.
    "On the Internet, I went to the most respected institutions in the country: the National Institutes of Health, the Mayo Clinic and — for my condition — the American Association of Digestive Diseases," she explains.
    Ticehurst discovered that all these sources agreed with each other: a high-fiber diet, rather than a severely restricted diet, is the key. She and her doctor have since followed this approach with a much more effective and pleasant result.
    Internet solutions are only as good as the sources they use and the quality of scholarship of those who interpret the sources. Each source also has its own bias.
    "If you go to the universities, you know what their frame of reference is, so you can get excellent information there. You go to the alternative health care sites and see what they have to say, and they have a certain bias, too," says Dr. David Jones, an Ashland physician. Jones has practiced medicine in the Rogue Valley since 1977 and is a former chief of staff at Ashland Community Hospital.
    According to Jones, many universities receive funding from pharmaceutical companies, and the solutions they provide on their Web sites often reflect this bias. On the other hand, many alternative health care sites push their own products. With so much uncertainty, it can be difficult even for physicians and patients to draw conclusions.
    "This is a dicey business — being an adviser when you are really honest about what you don't know — because you're making judgments in a sea of uncertainty," Jones says.
    For patients determined to be informed about their condition and use the best-quality information, there is no substitute for hard work with mouse and keyboard.
    "I look at subscription databases, knowing that people who are published in professional journals, those are peer-reviewed and have a little more authority," says Ann Magill, a retired Ashland High School librarian who devotes significant time online for health care advocacy research and to help friends research their medical conditions.
    Magill finds the New England Journal of Medicine database especially helpful. The Jackson County Library System has a subscription to this and other databases, so use is free. Magill also looks at the free Mayo Clinic Web site and checks headlines from the New York Times for medical news.
    "After a while, you get to know which writers are authorities, and then you can follow these writers," Magill advises as a strategy for following health-related issues in the popular press.
    With a small investment, the resources of Southern Oregon University are available.
    "For $45, you can join Friends of SOU and have access to their databases. You can go to their library and use their print resources, but you can also use the online resources from home," Magill adds.
    Her research paid dividends when it came to treatment for hypertension.
    "The doctor was trying to save me money by prescribing a drug that works for most people, but it caused a lot of coughing and sleep deprivation for some people, and the doctor insisted that this was the best thing," Magill says.
    In the end, her Internet research taught her much more than the best treatment for one condition.
    "I learned I'm my own best physician. I think people have to trust their intuition about that kind of thing. I transferred to another doctor who was more sympathetic to things people discover on their own and work well for them," Magill concludes.
    Magill's experience is part of a trend in which the Internet is changing the ways patients interact with their doctors.
    "People ask doctors more intelligent questions based on information they found on the Internet," says Charles Jaeger, associate professor in the SOU School of Business. Jaeger teaches a course titled "Medicine and the Internet," which explores the way in which the Internet is changing health care.
    Jaeger often turns to the sites WebMD (www.webmd.com) and the Centers for Disease Control and Prevention in his own research.
    "In the future, people will be more in control of their own conditions, rather than doctors controlling all stakeholders," Jaeger predicts.
    Daniel Newberry is a freelance writer living in the Applegate Valley. Reach him at dnewberry@jeffnet.org
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