One day while Dr. Leslie Ellwood, a pediatrician at Fair Oaks Medical Center and chief of pediatrics for Kaiser Permanente Mid-Atlantic States, was acting as an online physician on Kaiser's Web site, he was "chatting" with a woman who thought she had a minor medical problem.
After asking her some questions, Ellwood suggested she contact her primary-care physician, believing the woman had a more serious heart condition.
"We're always screening people. If we think they need to see their doctor, we tell them," Ellwood said. "We avoid making diagnoses or giving prescriptions, because we're not seeing them."
Technology has allowed people to search the Internet for medical advice and even avoid visiting the doctor's office, but not everything on the World Wide Web is trustworthy. For that reason, local health-care providers such as Kaiser and Inova Health Systems have their own Web sites, where people can search for information, access members-only pages or link to other sites.
<bt>Other reputable medical organizations have also turned to technology as a tool to educate the public about medical advances or how to treat the common cold.
One site, MEDLINEplus, created by the National Library of Medicine, pulls together all the consumer-friendly medical literature available and compiles it in one location.
"We saw there was so very much on the Web and it could be too much for say my mom or her mom to figure out where was it coming from and which to believe," said Eve-Marie Lacroix, director of the public services division for the National Library of Medicine. "We created the Web site to bring together authoritative information."
Lacroix said the site gathers educational information from scientific and creditable sources and does not accept advertising. The Library does not write any of the information that appears on its site.
It has also created a second site, ClinicalTrials, which is a database of all Federal Drug Administration approved clinical trials.
"I make sure I direct people to reputable sites," said Dr. Ted Chambers, a vascular radiologist with Inova Health Systems. "Medicine is not rocket science. If there is a disease process, the patient can learn about it for free. The Internet is strictly about keeping patients well-informed."
Chambers said he uses the Web as an educational tool for his patients and their families, and in turn it helps build a stronger partnership between the doctor and his patients.
"People can be skeptical about physicians," Chambers said. "The information gives them a sense of control."
<mh>Finding Creditable Information
<bt>Ellwood said the members-only service on Kaiser's Web site gives patients the opportunity to talk with a physician or advice nurse without going to a doctor's office.
"We find that 15 to 18 percent, after working online, can take care of themselves," Ellwood said. "Our aim is to educate people."
It has also helped the doctor in his own face-to-face practice. As an online physician, he has had to learn to communicate with the patients differently, using short explanations and less technological language.
"It gives me a greater perspective of people," he said.
The site also provides the opportunity for patients to talk with each other and act as support groups. Kaiser patients need a personal identification number (PIN) to access the members-only page. A PIN can be requested through the Kaiser Web site.
As for finding creditable information on the Web, Lacroix said the Library has a strict policy about what it will post on its site. That policy can be incorporated by anyone looking to find information on the Internet. She said the information has to come from a recognized and creditable source in the medical community. It must be dated, since medicine is an ever-evolving field. The organization must have an advisory board made up of experts in the field of the subject matter. And the material must be easy to read.
"It's getting a lot easier to find good content, if you know what to look for," Lacroix said. "MEDLINEplus [which was created in 1998] is the most-used resource for medical literature."