Your patients and an estimated 90,000,000 other
people in this country2 are among
the growing number of users of the Internet for communication, business,
purchases, and information. The changing doctor-patient relationships
under managed care, as well as other time pressures, have increased
the demand on both the patient and the physician for medical information.
The Internet is increasingly used in our daily lives as a means
of communication and commerce, and our patients see use of the Internet
as a resource for information on health and wellness as a natural
extension. The quality of this information, however, is extremely
variable. Our patients would not drink water from a source they
did not trust, and a source of medical information should be subjected
to equal scrutiny.
Physicians have traditionally advised their patients about what
to do and how to do it, and they have been respected for the guidance
that they have provided. Patients are counting on the medical profession
to maintain this role, and many are looking for the decision-making
process in health care to revert to the hands of doctors and their
patients. Physicians and medical groups as well as our educational
institutions are currently harnessing the potential of digital medical
information to assist in the personal encounter between physicians
and the public. Eighty-five percent of physicians surveyed are currently
using the Internet, an increase in online activity by doctors of
875 percent compared with that reported in 19974.
While no web site can provide the comfort of a caring physician's
touch or words, web sites can be used to allow a more informed and
productive encounter.
Requests for more health-care information from the Internet stem
from consumers' strong and growing desire to be more proactive in
their health-related decision-making. They want access to a reliable
and credible electronic medical database that will help them to
participate in medical decision-making. Patients' use of the Internet
should not be ignored, but rather it should be fostered and guided.
A better informed patient, along with patient-centered care, allows
more time for the development of the important doctor-patient relationship
and has been shown to improve compliance and outcomes7.
Health-care information on the Internet is a resource of unprecedented
size that provides a tremendous opportunity for us to partner with
our patients. Most individual physicians do not have the time or
skills to build or maintain a web site that will inform or attract
patients on a sustained basis. Medical web sites are being created
by academic centers and respected medical organizations for groups
of physicians and their patients. For organizations such as the
American Academy of Orthopaedic Surgeons (AAOS), the Internet is
an opportunity to provide its fellows with valuable communication
tools.
There are now many competing medically related sites, and it
is no longer adequate simply to build a site and expect it to attract
significant traffic. A web site can be more of a minefield than
a field of dreams. The web sites that do not have a legitimate economic
foundation or a well thought-out business plan will not succeed.
E-commerce is not the future but the present, and it is projected
to complement, not replace, traditional commerce. Search engines
are not able to separate substance from snake oil. Dot.com fever
has produced medically related web sites that can be a medium for
unregulated medical information with scientific jargon and testimonials
that are not easily distinguished from reputable data. The hazards
of point-and-click medicine are matters of deep concern to many, but
others seem less aware of these dangers.
An estimated 20,000 to 25,000 web sites are devoted to health
care1, and approximately 70,000,000
consumers have searched these sites for medical information over
the last year6. According to a
recent survey, 40 percent of all searches on the Internet are for
medically related information5.
Seventy-five percent of your patients or their families are seeking
online health-related information. Surveys have shown that these
patients are seeking more and better-quality health information
about disease treatment and prevention3.
Consumers have favored sites that not only provide information in
an easy-to-read format but also combine interactivity with quality
and encourage rather than disrupt the patient-physician relationship.
Physicians have traditionally been the providers of medical guidance
to their patients, and they continue to be the most trusted source
of health-care knowledge.
The new AAOS web site for patients and the public is dedicated
both to its traditional educational role and to improving communication
between orthopaedic surgeons and their patients. It is committed
to providing validated orthopaedic information. The site is patient-centered,
physician-driven, content-rich, and subject to the quality measures
of traditional publications. With its site, the AAOS has sought
to create a digital database of orthopaedic patient knowledge and
to have that database serve as the interface between the public
and current orthopaedic medicine and technology. Its content is
designed to serve as an information resource accessible through
the patient's physician and not as stand-alone medical advice. It
aims to humanize the online patient experience and to power the
deep need for the public to better inform itself about health-related
matters. The technology is directed toward strengthening the bonds
between physicians and patients and enhancing clinical-encounter
skills. It has been developed to be sensitive to diversity and readability.
The Internet mantra of content, connectivity, and commerce has been
changed to add credibility as its priority, in order to be an ongoing
resource for returning visitors.
On the AAOS web site, visitors may search for subjects by anatomy
(such as hip, knee, or spine), activity (such as running, exercise,
or ladder safety), sport (such as football, sledding, or baseball),
or injury (such as ankle sprain, anterior cruciate ligament tear,
or fracture). Topics such as fitness and wellness, injury prevention, surgical
procedures, rehabilitation protocols, and health policy are available.
More than 150 titles are currently online, and content development
by a professional writing staff in collaboration with orthopaedic
specialty societies is ongoing.
The AAOS web site is part of a unique partnership with the public,
the Fellowship, its patients, and quality educational content. The
site contains a collection of patient-education materials that have
been reviewed for accuracy and timeliness. These materials, which
have been formulated to create better communication between doctors
and their patients, are ready to be viewed and downloaded by patients.
The Fellows can direct their patients to their own web sites, created
with links to the AAOS content. The AAOS web site helps to incorporate
the Internet into physicians' practices to improve patient satisfaction
and compliance, and it can be a source of patient self-referral.
The linked web site can serve to humanize the online patient experience; to
inform and educate patients; and to dynamize the interaction of
physicians and their patients with fresh thinking, new approaches,
and enhanced communication.
Your own web site is now available from the Academy, without
charge, as a benefit of membership. Your customized web site can
be personalized with your practice philosophy and focus, photograph,
educational background, and affiliations. A web site can reach out
to each community and can connect you and your patients to the AAOS
content. To start building your site, all you need is your Academy
membership number and access to the Academy site at www.aaos.org.
You will provide your patients with access to quality orthopaedic
information and resources and your practice with enhanced communication.
Stuart A. Hirsch, M.D.
Chairman, Council on Communications
American Academy of Orthopaedic Surgeons
6300 North River Road
Rosemont, Illinois 60018-4262