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The WWW is redefining clinics and from panacea to placebo, the Web has it all, says Peeyush Agnihotri FOR doctors and quacks, patients and hypochondriacs, the cyberspace has donned the white apron of a consulting physician and is toting a stethoscope. The 3W is redefining clinics and from panacea to placebo, the Web has it all. Like the benevolent self-driven granny, who used to hurl solicited as well as unsolicited advice on health issues in her locality, the Net has an explanation and remedy for any and almost every ailment, right from rash to rheumatism. Only this time even the doctors are consulting this e-granny. Resource for patients, docs For nervous patients, it has a soothing effect. Take the case of Shyam Sharma, a Punjab government officer, who was advised bypass surgery after a heart attack. "I was both curious as well as tense. I wanted to know what was wrong with my life-style and what post-operative precautions should I take. I just logged on to the Net and not only did some doctors whom I e-mailed, provide me with free advice; I could also browse through a whole lot of literature on the related issues. The result - consultants discussions that earlier seemed like an incoherent blabber seemed to make sense and more importantly, I was mentally prepared for the days to come. I sought reassurance and it came from cyberspace," he says with pun intended. No one has cast aspersions at the vast resources that the Net carries. Even the doctors are wading through the Net to be abreast with the latest that has been done in their field. More so the practising physicians who just cannot afford to miss what's on globally in their field. "If you do not remain up-to-date, chances are patients may start looking for someone who's more savvy. You see, most of the patients have their relatives abroad who pass on the line of treatment and latest advances in their country to the sufferer. Secondly, the patient clicks and browses to see how he can get rid of his problem. So if a physician doesn't brush up his knowledge, she is outdated," says an obstetrician who asked not to be identified. In a way, the Web is
a doctors' friend and guide and not their rival. "The trend
indicates that the number of those seeking medical advice through the
Net has increased by more than 50 per cent here in India. Still there
is a vast, untapped market and the Net can emerge as a very powerful
tool for doctors and consultants. Just last week, I was in Bhubneshwar
discussing these issues," says Dr B.D. Gupta, Professor Emeritus
from the Department of Radiotherapy, PGI, Chandigarh, currently
working on Telemedicine projects.
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The Web is fantastic and can lead the surfer through a vast diversity of resources. Right from those who sell lizard oil for virility to chat session on Viagra. This might even confound the man in front of computer. For example, simply type 'sexual disorders' on one of the search engines and the Web would throw up 4,78,000 results. To wade through such humungous data would take a very long time. Naturally, quackery too abounds. Unfortunately, the Net just compiles and collates information. It cannot read the intentions of the man who posts his material on the Web. The quality of information is variable, disarrayed and at times, poor. Then there are a lot of sites that are more of an advertisement telling the surfer in distress how Mr XYZ was in pain 'till he discovered us and our treatment and is now a happy-trouble-free soul.' All this with a smiling double-column photograph of Mr XYZ. The photo could very well be before the fellow received treatment. Who knows? Anyone can package information and brand it authoritative but how reliable could that be? Take the following case as an instance. If a person suffering from psoriasis, a skin disorder checks in at www.skincarephysicians.com/psoriasisnet/treatment.htm, he or she is curtly told: "Psoriasis is a chronic disease that is seldom cured. However, effective treatment may provide partial or full remissions for substantial periods of time." On the other hand visit http://drchandra.hypermart.net/testimonials.html, another site on psoriasis and the doctor claims to cure this disorder completely. She also has a positive anecdote to narrate on site where a patient was actually 'healed by her.' Confusing. Isn't it? This might not make a difference to us as browsers but ask those who suffer from psoriasis. Similarly, a problem that gives nightmares to some men in their mid-30s or early 40s is that of baldness. A lot of sites promise to cure it pronto and all kinds of hair oil are recommended. "A lot of information is available on the Internet and there are many unethical practices prevalent on the Net. On our site, we always recommend that our readers to consult a doctor or dermatologist before they start any hair-loss regimen with us. However, since many hair-loss products are botanically-based such as herbs and dietary supplements that are readily accessible to everyone without a prescription, many choose to by-pass visiting a doctor," spokesperson of Hairsite.com, a baldness cure portal, told Login Tribune. The spokesperson agrees that baldness cannot be completely cured. Self-medication
The Net may even act as a tool to flare up hypochondria. Pain in back could mean anything from a mere muscle pull to a slipped vertebrae and this may give nightmares to those suffering from the ailment. There are big gaps in information offered and the surfer is the best judge in all cases about what exactly he seeks and from how many sites can he club the desired information. Self-medication is also proving to be a real pain. As V.K. Noheria, a practising Panchkula physician, narrates a case: "A patient who was suffering from Herpes Zoster used the 'click' method of treatment. He browsed through all literature and found a medicine that he thought was suitable. He self-administered it and landed up in PGI, Chandigarh, as a case of misdiagnosis and drug reaction. Minor ailments like cough and cold can be cured but for bigger problems the Net can never substitute a doctor," Noheria says. Rajesh Bansal, a paediatrician agrees: "The Net can never a substitute for a doctor. One medicine may be good for a fixed line of symptoms but the same medicine may prove harmful if just one symptom is different. Then various persons react to various salts differently. How can a patient get okay unless he sees a good doctor," he asks. Diverse claims Those in distress try every possible means to get rid of the illness. Remedy through magnetic therapy was the latest to hog the limelight. However, few studies have been published on the effect of small, static magnets on pain that is marketed to consumers. Those who sell it vouch that magnets increase circulation and reduce inflammation. They even cite a study from Baylor College of Medicine in Houston done on patients with knee pain where the result was marginally in favour of those who received treatment through magnetic device. However, detailed painstaking research at the New York College of Podiatric Medicine, USA, and the VA Medical Centre in Prescott, Arizona, USA, showed that magnetic therapy is a sham. In a nutshell, the thrust is -study thoroughly before you actually reach out for a pill. Affect on clinics Is this affecting the doctor's business in any way? "No. At least not of orthopaedicians and those in the field of surgery. But new generation is logging on the Net to find remedy for very minor ailments. General physicians have however suffered, though in miniscule proportion," says M.S. Gupta, an orthopaedician. On the Net, the protection of electronic records containing personal health information of patients also needs to be taken care of. The mode of payment to a consultant is usually the same as is done in other online shopping sites and those in this field say that it is an area to watch as a revenue-generation model. "Healthcare is one of the top sought-after subjects on the Internet worldwide. People are widely using online consultancy for a second opinion from specialists. Seeking opinion through the Net in case of emergencies or in case of long distance specialised consultancy plays an important role. E-commerce at a lower level, i.e., for general consultancy is not being looked up in a major way, but can become important in case of specialised consultancy and services," says Dinesh Aggarwal, CEO of Indiamart, a B2B and B2C portal. The Net can be accurate to a fair degree but for actual treatment you'll have to depend on the doctors with a genuine degree in medicine. The Web can supplement the information about the line of treatment but can it act as a doctor by proxy? Never.
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