More US adults consult the Internet for health information every day than go to doctors – and physicians are none too happy about it, said Tom Ferguson, MD and publisher of The Ferguson Report (www.fergusonreport.com), during a talk, "The Net-empowered Patients: Reality and Perceptions" on January 30 in Kresge G-3. His talk was largely based on work he and his colleagues have done at the Pew Internet and American Life Project in Washington, DC, where Ferguson is a senior research fellow for online health. The talk was sponsored by the Dana-Farber/Harvard Cancer Center, Tufts University School of Medicine and Emerson College School of Communication and was part of the "Medical Messenger Series," a Boston-wide lecture series that brings together professionals in health science, journalism and communication.

"The idea of using technology to promote health care and health education is critically important," said Karen Emmons, an associate professor in the Department of Health and Social Behavior, who helped organized the lecture. "The landscape has changed dramatically, and we need to change with it."

Each day, approximately seven-and-a-half million people use the Internet to get health information, whereas less than three million consult their doctors, said Ferguson. In fact, of the 110 million Americans who surf the Internet, more than 60 percent use the resource for health advice. "E-patients" like the Internet, he said, because it is convenient, comprehensive and anonymous.

But many doctors try to discourage their patients from learning about health on the Web, said Ferguson, because they believe there is too much misinformation floating out there.There is reason for their concern. A paper cited by Ferguson and currently in press has found that the accuracy and completeness of health information on the web ranges from 15 to 85 percent, depending on the web site.

Unlike their doctors, e-patients are confident they can differentiate between the good stuff and the bunk. Even though they are aware that wrong information pervades some web sites, most e-patients consider the Internet a reliable and valuable source of medical information and advice. More than 90 percent of respondents to a recent Pew study said that they found the answers they were looking for the last time they did a health-related search, and nearly 90 percent of the respondents said that the information they found improved how they took care of themselves.

One of the more surprising aspects of the research, said Ferguson, is that e-patients are more likely to look for information for other people, such as a sick spouse, child or parent, than for themselves.

There is another reason why doctors discourage consulting the Internet for health data. Doctors have been trained in the era of "Industrial Age Medicine" in which physicians were considered the primary source of professional care and advice, the conduit through which medical science was dispersed, said Ferguson. Self-care, though always part of health care, was rarely addressed in standard medical teaching, he said.

Today, growing numbers of Americans are living in an era of "Information Age Health Care." They see themselves at the center of an information system with multiple sources, only a few of which require face-to-face contact with a health professional. These e-patients want doctors who can be facilitators and partners.

Ferguson sees many opportunities for patients and doctors to use the Internet and other technologies to their advantage. One growing trend is for doctors and patients to e-mail each other about non-urgent matters. Ferguson reported that the doctors who do this with their patients like the ability to respond to questions more deliberately and at their convenience. Some have even typed up standard, comprehensive responses to common questions.

Online support groups also provide people with advice and information that may not be otherwise available to patients. People are "amazing" in their willingness to divulge their personal stories and medical experiences in these groups with the hope that they will either help someone else or be helped, said Ferguson.

In one of the surveys he published in 1999 in The Ferguson Report, he said that more than 75 percent of e-patients reported that online groups gave them better in-depth information than either medical specialists or primary care physicians.

Ferguson concluded that economics and consumer pressure will force more doctors to face the realities of treating Internet-savvy patients. Large health care systems will eventually turn to the "Information Age Health Care" paradigm, he predicted, and when they do, "there will be huge forces on doctors to go into this model because this is what the end-user really wants."