Members of the medical profession are making use of Net's myriad resources
Are doctors getting Net savvy, I ask Dr P Chowdhury, an anaesthetist at a leading hospital in Meghalaya. He gives me his five email addresses, shows off his newly acquired computer equipped with the new Intel® Pentium® 4 processor, his snazzy Web cam and HP colour printer and asks with a flourish, "Any doubts?" A few years ago, the same doctor didn't even know there was something called the Internet!
It was not uncommon a few years ago, to find doctors, especially older and more established ones, who shied away from the Net. They were after all, more comfortable wielding the stethoscope, than the mouse. But the scene has changed. With the emergence of the SARS threat, the Net has become the best place for updated information, in the absence of much printed material.
Dr Hufrish Suraliwala, medical information manager at Health Education Library for People (HELP), located in Kemps Corner, Mumbai feels that older doctors are overcoming their discomfort and embarrassment to find out more about the Internet. Younger doctors who have used the Net during their studies obviously don't face the same hurdles.
This particular library is quite unique. It has entered the Limca Book of Records 2003 for holding the longest series of health awareness talks, which are not only free, but are open to anyone interested. A few years ago, HELP started providing free Internet training to assist doctors get over their 'mouse attack'. Its online component has separate sections for doctors and patients. In partnership with mdconsult.com of USA, it also provides online subscriptions to medical journals.
The training programme covered the basics on retrieving medical information, tips for quality searches and demonstration of the online subscription service. "We got a great response from a variety of medicos ranging from academicians, specialists to general practictioners," says Dr Suraliwala.
Today, many of the doctors who were introduced to the Internet still drop in to use their services, including a physical library, consisting of a large collection of medical books and publications. Members of the public often browse through the library, or borrow medical books at a nominal charge.
Dr Amit Maydeo, director and chief endoscopist at Mumbai's Digestive Disease Centre, began using the Net more than eight years ago and says it has become an invaluable part of his work today. He often communicates with international doctors and patients alike via email. All enquiries are handled online. The Net is especially helpful for preparing material needed for conferences and finding updated medical information. Dr Maydeo has also used the Net frequently to download medical papers and pictures.
CD Mohatta who maintains the medical information site valuelife.com points out that doctors (except dentists) in India do not need to renew their license. This might be one of the reasons they do not actively seek out the Net for updated information. "A doctor can practise for decades without getting any knowledge about the new discoveries. While in the US, you have to keep abreast of the latest because of compulsory continuing medical education," points out Mohatta.
Valuelife.com's latest issue deals with the problems of SARS and skin cancer and Mohatta feels that the Net can play an important role in disseminating in-depth information. "Normally most sites or newspapers only give stories. But deeper insights are not available," says Mohatta, who hopes that sites like valuelife.com will fill that void.
It's not only doctors who benefit. Take the case of this Melbourne based Parsi gentleman. Knocked down by a drunk driver about 10 years ago, he contracted what is called 'Tarlov cyst' syndrome. However, no one was ready to believe it, as very less is known about this rare condition. He was even called mentally unstable and lost his job. The gentleman found out more about the syndrome from the HELP's vast online resources. Furthermore, a special package on the condition was prepared and emailed to him.
Soon thereafter, HELP got an order from a Florida based lady on the same condition, and was directed to an expert in her area. Dr Suraliwala says that most of their research is done with the help of online and library resources. A patient or doctor located anywhere in the world can ask for information regarding specific conditions and it can be either emailed or couriered to them for a nominal charge. They often get such email orders from people in the US and India.
About the credibility of online medical information, Dr Suraliwala says medical sites should be approved by the Swiss based HON Foundation and also updated frequently. Dr Maydev uses the PUB Med medical search for useful documents and papers.
Dr Chowdhury is still getting the hang of his online experience, and says that the National Medical Library and British Journal of Anaesthesia are sites he visits for information on his specialty field. These days, however, he is on a different quest. Besides discovering the late night joys of chatting and playing games, he's busy looking for sites that offer medical placements overseas!
"Sites offering remedies for SARS not credible"
With the increasing threat of SARS, there has also been more than hundred sites that have sprung up online, claiming to offer alternative therapies. But how credible are their claims? We ask some health experts.
CD Mohatta says these are unknown people offering unknown remedies to innocents. One should only consult a specialist and also collect more information oneself.
Dr Hsu Li Yang of the Center for Infectious Diseases, Hong Kong says there is no known treatment for SARS at this point in time. "Even the Hong Kong regimen of ribavirin and steroids (as published in the Lancet journal a week ago) does not work. There is just no basis (not even hypothetically) for their claims," says Yang. He advises Net users to view all such sites with a great deal of skepticism, not least the ones already mentioned.
Li Yang says that while the information given in sites like askearth.com might be reasonably accurate, World Health Organization's and Center for Disease Control, Atlanta's offer the most reliable information. He also recommends Program for Monitoring Emerging Diseases (ProMED) for up-to-date information.
Iain Simpson of the Communicable Diseases Programme at WHO writes that "no treatment which claims to cure the SARS virus should be believed."
"There is no treatment for the SARS virus, although infected patients can be given supportive care, including treatment for fever, assistance with breathing, etc. This is the treatment that works, although much more work is being done on testing antiviral drugs and on developing a candidate vaccine," he informs. He also recommends that readers visit the WHO sites updated at least daily.
The US Food and Drug Administration (FDA) in a recent press release informs of a crackdown on Internet marketers of bogus SARS prevention products, by the Federal Trade Commission and FDA.
"A coordinated Internet surf found 48 sites touting a wide variety of SARS treatment or prevention products," says the release. The two agencies have also sent warnings to Web sites operators and email solicitors, cautioning that it is against the law to make claims about SARS protection, treatment or any other health benefit.
"Scam artists follow the headlines, trying to make a fast buck with products that play off the news. Our message to e marketers making deceptive claims is 'change your site to comply with the law.' At the same time, our message to consumers is 'hold on to your money.' No products have been found effective in preventing, treating or curing SARS," says Howard Beales, Director of the FTC's Bureau of Consumer Protection.
CDC also warns that "Concerns about a medical condition--either your own or that of a family member--should always be addressed to your primary care physician for advice and care appropriate to your specific medical needs."
Sites recommended by the CDC
- Interim guidance on infection control precautions for patients with suspected SARS and close contacts in households