Those in charge of selling the Internet to physicians certainly don't lack for hyperbole.
Witness a recent wide-eyed pronouncement from IBM Global Healthcare Industry President Russell Ricci. At the May 10-12 e-Healthcare World exhibition in Chicago, Ricci declared the Internet "a fundamental chance to restructure, for the first time in a couple of thousand years, how we deliver healthcare."
The Internet may well turn out to be the best thing to happen to medicine since the Hippocratic oath. But first, other speakers at the conference pointed out, the widely different attitudes physicians and patients have toward the Internet need to be reconciled. Namely, physicians view the Internet as a means to confer with colleagues, while patients want to use it to communicate with their doctors.
At best, speakers said, the Internet could provide true managed care by giving patients the information they need to manage their health, while also giving doctors the information they need to better treat patients.
If physicians are slow to accept what consumers want, however, the Internet could turn doctors into what many speakers called "auto mechanics of the body."
If this were to happen, patients would visit physician offices with reams of information about their maladies and demand that doctors do only what they're told.
"Doctors will change or be changed," says Steven McGeady, vice president and content director of chipmaker Intel Corp.'s Internet healthcare division.
"Whether you think (the Internet) is a good thing doesn't matter -- it's happening. You can't regulate it out, and you can't wish it away."
The topics and views debated at the e-Healthcare conference came forth without much rebuttal from physicians. Most of the 800 or so attendees were technology company representatives, consultants, venture capitalists and others not directly involved in clinical fields. Many were there to discuss potential business partnerships.
That's not to say physician concerns weren't on attendees' minds. Many discussions centered around how and when doctors would use the Internet to manage both the clinical and business aspects of their practices.
Many speakers agreed that patients will drive these decisions.
"Doing things to the consumer is out," says Douglas Goldstein, president of eHealth, an Alexandria, Va.-based Internet consulting firm. "Doing things with the consumer is in."
Several speakers cited a February poll by New York-based Louis Harris & Associates showing that 68% of adults with Internet access seek medical information online, making it the most popular subject, followed by personal finance. As a result, big money is being pushed into healthcare via investments in consumer-oriented Web sites and software to link physician offices with patients' home computers.
For example, New York-based OnHealth, which operates a consumer-health Web site that generates $100,000 in annual revenues, plans to use money provided by investors to launch a $20 million advertising campaign. OnHealth is one of at least 20 major consumer sites among an estimated 15,000 healthcare-related sites.
McGeady says consumers are using the Internet to get healthcare information because they're not sure who they can trust.
"They don't know if doctors are delivering information or if they're covering for HMOs," McGeady says. "People feel responsible to take control of their own health. They're pretty sure no one else is going to do it for them."
Meanwhile, other speakers say the Internet holds the promise of quicker responses to patients' questions. Ian Sutcliffe, president of Hamilton, Bermuda-based Mediconsult.com, says his library staff can answer within an hour up to 90% of e-mails asking various medical questions. The site gets 2.3 million visitors per month.
Other speakers say the only way for doctors to compete is to communicate with their patients by e-mail.
However, speakers said they sense that any physician resistance to technology may be breaking down with the Internet. An American Hospital Association representative who stood up during one seminar and referred to doctors as "technophobes" drew the ire of the few physicians in attendance. The doctors said they're only afraid of expensive technology that doesn't work.
Internet gurus aren't taking a dim view of physicians' role in healthcare. They say they give power back to physicians through technology that offers more information at less cost than current office-based electronic medical record systems.
"Our focus is to bring the physician back into the middle of the picture," says Sundeep Bhan, president of New York-based physician Web site Medsite.com, which sells books and supplies and offers e-mail and other services. "How many people, when their leg hurts, go to a health site? The doctor-patient relationship is our strategy."
Healtheon Corp. and WebMD, both vendors at the e-Healthcare World show, are trying to further reinforce the doctor-patient relationship through their planned merger, announced May 19. Although it wasn't discussed publicly during the show, the deal would combine Santa Clara, Calif.-based Healtheon's Web-based services for doctors, hospitals and payers with Atlanta-based WebMD's Internet services for doctors and patients. The merger is expected to close by year-end.
Healtheon went public in February, and WebMD has only existed since September. However, both companies received huge early boosts from high-profile financiers and are considered the lead dogs in the race to go online.
Hoping to solidify its online position, Portland, Ore.-based MedicaLogic appeared at the e-Healthcare World show pitching its conversion into an Internet company from an office-based system producer. The company is spending $100 million to convert its office-based system, currently used by 7,000 physicians, into an Internet-based system.
One change in the MedicaLogic product includes a link to allow patients to use the Internet to view their own medical records, an idea other companies also areb pitching as Congress debates online medical record privacy.
"What we realized is that the patient can benefit more than anyone else from this information," says Mark Leavitt, M.D., MedicaLogic's chief executive officer. "It will intensify, and in some cases reconstruct, the relationship between the patient and the physician."
While some vendors and speakers sold the idea of Internet technology being as touchy-feely as an office visit, others espoused the notion that, if nothing else, the technology would make a physician practice cheaper to operate.
Terry Lee, president of Dallas-based Claimsnet.com, says his company can electronically process a claim for 35 cents to 50 cents, compared with $1 for a paper claim, and reduce the turnaround period to between seven and 21 days from between 60 and 90 days. Claimsnet.com says it had 2,000 physician customers at the end of March, which is twice as many as it had three months earlier.
But McGeady says the Internet is so necessary that questioning its return on investment is like "asking the ROI of electricity."
Leavitt says Net-savvy medical students and younger physicians already feel that way. As for other doctors, McGeady's statement may be just another example of a believer's hyperbole.