As early as November 2001, the increasing popularity of Internet consultations without a previous relationship between physician and patient was well recognized, enough that Swedish researchers conducted a study that lasted through January 2002 to “investigate how an Internet-based Ask the Doctor
service without any preexisting doctor–patient relationship was used and evaluated by the enquirers.” Their findings, published in April 2006, show that such services are appreciated for their convenience and flexibility and the ability for users to reflect upon diagnoses, second opinions, and advice from a physician as opposed to attempting to remember conversations during a face-to-face meeting with a doctor.Online Medical Consultation Services
Dozens of sites have popped up during the past six or seven years, and even earlier, offering advice (see Online Medical Consultation Services
below), diagnoses, second opinions, and even prescriptions from doctors who never physically meet the person with whom they are consulting. Dale C. Alverson, MD, Medical Director of the Center for Telehealth and Cybermedicine Research at the University of New Mexico Health Sciences Center
, and also board of directors member, Center for Telehealth
, told OncNG
that the popularity of such sites has risen “because of the gaps in access to services and the limited resources that we have to provide services. The tools of telehealth— the information communication technologies—offer opportunities to reach out to people who need services they can’t receive easily and also provide a way for healthcare professionals to virtually extend themselves to those people.” Further, the anonymity such sites offer to patients has also spurred their interest. “If you want Viagra or whatever it may be, and you don’t want to go to the doctor, that’s one way to get it. It’s a huge marketplace,” adds Rob Sprang, MD, Center for Telehealth & E-Health Law board of directors, and director of Kentucky TeleCare
, University of Kentucky College of Medicine.
Included among these sites is YourDiagnosis
, where individuals seeking health information provide answers to a comprehensive set of questions regarding weight, diet and other habits (smoking, alcohol intake, exercise, etc), immunizations, current medications and health supplements, current and previous family and personal health issues, presenting symptoms, and other factors. The information provided is aggregated to produce a thorough report that displays all replies entered, suggestions regarding what to do based on them, and the probability of certain diagnoses and their urgency.
Patients can then save their summary and, for $50, obtain comments on all aspects from a physician and ask a medical question to be answered by that physician. Users can also conveniently link right to the sister site YourNetDoctor
, where questions can be asked of a general physician for $60. Similarly, Online Medical Diagnosis
“a diagnosis and treatment program that uses medical specialists to accurately diagnose symptoms…with a program created by 1,500 specialist physicians”— and its sister site Online Medical Treatment Advisor
—“a treatment program that uses medical specialists to accurately select the best and newest treatment for each patient, based on individual patient’s characteristics”—offer their services through a one-year subscription of $9.99.Pretenders
Without regard to safety, it’s clear why patients would want to take advantage of the services provided by the above sites, but we can only speculate as to why a US oncologist would participate (please e-mail us at firstname.lastname@example.org
if you participate, know someone who does, or have thoughts on the matter). Although Online Medical Diagnosis lists its associated physicians, no contact or affiliation information is provided, and when we searched for the individuals using Google and Yahoo, either no actual physician turned up or the name was so common that it would be difficult to determine who was the physician in question. Further, e-mail messages sent to the only site listing direct contact information for its doctor(s) and other staff were immediately bounced back, and calls to corporate numbers lead to unreturned voice mail messages and/or a bunch of “I don’t know, let me transfer you to…”