What can the Internet do for me?
CMAJ 1997;156:1203
© 1997 Canadian Medical Association
This column was written by Warren Lampitt (warren@gretmar.com), information systems manager at Gretmar Communications. He and his wife, Timmins, Ont., family physician Karen Breeck (karen@gretmar.com), have been developing Internet resources for physicians for 2 years. Their flagship site, WebDoctor (see CMAJ 1997;156:1050 [full text]), now receives 450 000 document requests monthly. Current initiatives include construction of a virtual medical library for Ontario physicians and building specialty forums that allow family doctors to contact specialists via the Internet.
Why are so few MDs using the Net?
Although the Internet has been hailed as a great leap forward, fewer than 8% of Canadian physicians use it regularly. A combination of inexperience with personal computers and the Internet's chaotic nature renders this medium almost unusable to the uninitiated. In this and future articles, you'll learn about the Internet and some basic skills that will allow you to use it effectively to find medical information.
What is the Internet? As editor of WebDoctor, I was recently reviewing an article about the Internet when I had a revelation. The article read like most that pepper medical journals these days: the Internet is a massive network of inter-connected computers that share information. . . . It suddenly dawned on me why only 8% of physicians are online: the Internet, when described in the cold language of computer science is, well, boring.
Sadly, most of the articles I have read appeal only to those who find networking protocols interesting. For the many physicians who find computers an unwelcome invader in their office, we have to find another motivator to get them online.
Think this way: each month the number of Internet users is increasing by about 15%, and eventually at least 1 of your patients will get caught up in this mass migration. Picture this: that patient surfs the Net and finds one of the many "services" offering a diagnosis. Invariably, these programs all default to the diagnosis "You need a CT scan and specialist care -- call 1-800-5WE-CARE for an appointment."
Now you may have to cancel your next 2 appointments to spend 45 minutes persuading your keen patient -- "I'm entitled to this treatment" -- that he doesn't need an expensive and unnecessary procedure. As you're explaining this in a calm, professional manner, he is trying to remember his lawyer's phone number. If you just felt a cold chill, consider yourself duly motivated!
So where do we start? Rather than reciting the history of computer networking, I like to begin the discus-sion by considering the work of a Jesuit priest. Pierre Teilhard de Chardin, a paleontologist and priest, imagined that the next stage of human evolution would involve a "thinking layer" called the "noosphere," where humanity would develop a medium that would enable the instantaneous exchange of thoughts and ideas.
Through this conceptual membrane, de Chardin envisioned a world where intercultural barriers were shattered, leading to global peace and harmony. His vision was considered farfetched in the 1930s -- he was nearly excommunicated because of it -- but now it has a vehicle.
Through the Internet, a breakthrough in one part of the world can (theoretically) be communicated instantly to physicians worldwide. A family doctor in an isolated community can tap into a global knowledge pool to help manage her patient's care. But how does this happen? I'll discuss that in future On_the_Net columns.
Cool sites
www.fmrw.org
Drs. Sonny Cejic and Ken Milne, family medicine residents at the University of Western Ontario, have created a Web site to promote the development, interests and well-being of Family Medicine Residents at Western (FMRW). It is the first site of its type in Canada. One of its sections (Resident Central) is password-protected and accessible only by FMRW members; another (Maitre-Dee) "serves up" links to numerous Web resources. Milne (wmilne@julian.uwo.ca) believes the site can help address the chronic maldistribution of physicians in Ontario. "If new doctors can feel more secure with a vast resource at their fingertips, it will alleviate some of the isolation concerns expressed by young doctors working in more remote areas."
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