Snake oil on the Internet

Memo from the Editor

By Jeff Forster, Editor

Back in the 1970s, an American medical missionary ended more than twodecades of utter seclusion in rural China and emerged into a world he barelyrecognized. I remember his bewildered expression as he faced a horde ofmicrophones and shared his first impressions of late-20th-century civilization:"I can't imagine that all this . . . information . . . is conduciveto peace of mind."

I wonder what he would say today, now that we have scores of channelson cable, now that we have the Internet, now that the information explosionstages a daily assault on the eyes, ears, mind, body, and soul.

I realized how much the world had changed when I found a Web site forthe Franciscan Sisters and Friars of the Atonement in New York state (www.graymoor.org). They have taken vowsof poverty and chastity--but apparently not silence.

I'm truly heartened to find evidence of their good works on the Web.But if the information explosion can work in such mysterious and wonderfulways, it can also do harm at other, less benevolent sites. Forget--for themoment, anyway--the problems of sex and violence on the Net, and considerthe abundance of health-related information that lies but a click or keystrokeaway.

Much of it is very, very good, and holds great promise for improvingpublic knowledge and enhancing doctor-patient relationships. Unfortunately,much of it is horrid, and underscores the importance of vigilance againstmisguided, misleading, or even poisonous information.

In June, the Federal Trade Commission issued a Consumer Alert, warningthat "some unscrupulous marketers are using cyberspace to peddle 'miracle'treatments and cures to vulnerable consumers." For further details,simply go to www.ftc.gov and click onConsumer Protection. Complaints can be filed directly on the Web site orby calling, toll-free, 877-FTC-HELP (382-4357).

The FTC and FDA also issued warnings about unapproved HIV home test kitssold on the Internet. Meanwhile, the AMA and others are calling for legislativecurbs on the excesses of Web prescribing. It's the wild frontier out there(or in there, or wherever cyberspace actually exists). Authorities justshut down a Web site called get-it-on.com,which freely dispensed Viagra. The physician who ran that site is undercriminal indictment.

Sure, snake oil is as ancient as Hippocrates, but now it is incrediblyaccessible, worldwide. By one estimate, 46 percent of those who surf theNet are searching for health information. According to another report, some17.5 million American adults are turning to the Net for medical guidance--inmany cases, because they don't get it from their doctor.

Fortunately, a number of public-spirited health organizations have takenit upon themselves to evaluate the quality of what's on the Net and to promotethe good stuff while weeding out the bad. They include:

Internet Healthcare Coalition, whose mission is to promote "Quality Healthcare Resources on the Internet" (www.ihc.net).
National Council for Reliable Health Information, headed by Kansas City FP John Renner (www.healthscout.com ).
Quackwatch (www.quackwatch.com ), a site maintained by Pennsylvania psychiatrist and antifraud crusader Stephen Barrett.
Health Information Technology Institute of Mitretek Systems, a nonprofit company based in McLean, VA (hitiweb.mitretek.org ).
Another such organization, called the Health Information Resource Center, recently sponsored the first annual World Wide Web Health Awards, designed to help health professionals and the public find sites that offer accurate, up-to-date information (www.healthawards.com ).

The irony is that these organizations are fighting for what every conveyorof information--and information about information--is fighting for thesedays: the eyes, ears, hearts, minds, and souls of the body public. The challengeis to distill and interpret the overwhelming volume of information, makesense of it, and deliver a coherent message to the intended audience.

Come to think of it, that's the same task we set for ourselves in servingyou, the reader. Our mission is to provide you with the best and latestinformation and advice on medical practice, offered up in palatable, digestibleservings. As part of that mission, I promise you we'll join with all public-spiritedindividuals and organizations in combating bad health information conveyedthrough any medium, and in promoting the good.

"The rapid growth of the Internet and its use across many differentdemographic lines suggest that it is not simply a passing fancy but representsa fundamental change in how we obtain and share information," BrooksS. Edwards, a cardiologist at the Mayo Clinic, wrote in Minnesota Medicinein April. Edwards is medical editor of Mayo Clinic Health Oasis, a healthsite for the public ( www.mayohealth.org).He added: "The Internet is the open door to the information age andgives users access to knowledge previously unavailable. Medical Web siteusers can become better consumers of health resources and better partnersin the doctor-patient relationship."

Amen. As the Internet opens up the floodgates of information, patienteducation is more important than ever. Consider us your partners in thatendeavor, and call on us whenever we can be of help.

A final thought: Where the Internet is concerned, we'd all do well toremember a saying of the Buddha: "Believe nothing, no matter whereyou read it, or who said it, no matter if I have said it, unless it agreeswith your own reason and your own common sense."

By the way, I found that quote on the Internet.

Jeff Forster. Snake oil on the Internet. Medical Economics 1999;18:8.