The conventional wisdom that doctors do not use computers in the course of the workday is no longer valid: Physicians are now tech-savvy.
The computer has become an integral part of clinical practices, according to a recent national survey of physician Web usage, and a handful of physician executives and entrepreneurs have made running Web sites their jobs or their businesses.
A survey by Boston Consulting Group (BCG) and Harris Interactive shows 89% of physicians are using the Internet and 90% use it to research clinical information--numbers that run counter to the once-popular belief that physicians use their computers only for personal reasons.
"The sheer amount of migration to online access and knowledge-building online comes as a surprise," says Carina von Knoop, a BCG vice president.
The survey indicates the vast majority of doctors say health-related Web sites influence their knowledge, diagnoses and the types of drugs they prescribe--a response von Knoop says she had hoped for but did not expect.
Today, there is a medical Web site for almost every physician need: researching treatments and medications, finding a job, communicating with colleagues, reading online journals and completing continuing medical education courses.
Sites run the gamut from those with a broad purpose, like the National Library of Medicine's Medline and WebMD's Medscape, to those that target specific diseases or represent individual healthcare organizations.
Ease of use is a key Web site requirement for physician users, according to Jim Gaddis, director of e-strategy for First Consulting Group, a healthcare consulting corporation in Long Beach, Calif. "If using the Internet doesn't save physicians time conducting a daily activity or save money, they won't bother," he says.
Authoritative content is another important criterion, says Clyde Wesp, M.D., a pediatrician and medical director at Saddlebrook Memorial Care in Laguna Hills, Calif. "I prefer sites where I can ask questions of experts in the field and steer clear of sites sponsored by physicians," he says. "They are opinion only and not helpful to me as a clinician."
Wesp says he spends hours each day on the Internet and looks to Medscape to fill most of his needs. When he registers, content focuses on his area of expertise.
Vying for attention
Kirill Rikher, M.D., a Brooklyn, N.Y., family practitioner, is a Physicians' Online (POL) enthusiast, spending 12 hours or more per week on the secure, physicians-only network.
POL licenses news from Reuters, Medline and others. Rikher says he accesses POL, owned by Boca Raton, Fla.-based Cybear, to communicate with other doctors, find out about unusual medical conditions and access clinical abstracts.
"Physicians' Online is better than a shelf full of books," Rikher says. "You just ask a question or link to Medline and get what you need. I never dreamed it would be such a valuable instrument for my practice."
Medline, a product of the Bethesda, Md.-based NLM, part of the National Institutes of Health, offers references, abstracts and full texts from 4,300 biomedical journals.
NLM director Donald Lindberg, M.D., calls Medline the most searchable and reliable biomedical site in the world. Its companion site, Medlineplus, is for consumers, but Lindberg says many physicians turn to it for the latest treatments. He adds that 25% to 33% of doctors who use the site also use it to advise patients.
MDchoice, based in Somerville, N.J., goes beyond medical information by providing online, interactive education for physicians.
The site's Cyberpatient Simulator challenges physicians to make decisions about treatments for various conditions, while PhotoRounds presents brief interactive cases developed by doctors and accompanied by photographs. Calculators help with cardiac output and other measurements.
"To meet the needs of physicians, we wanted to make learning more engaging and effective by using technology to accomplish what print and lectures cannot do: involve the learner actively," says Ash Nashed, M.D., MDChoice CEO and founder.
Also an ER physician at Morristown (N.J.) Memorial Hospital, Nashed says MDchoice evolved from an idea he had to create a platform for ER doctors to share ideas about clinical procedures.
The quality stamp
URAC, a not-for-profit accreditation organization in Washington, D.C., is lending its stamp of approval to credible medical Web sites through its voluntary Health Web Site Accreditation program.
Sites must meet 53 standards, released last July, that include guidelines on privacy, security, quality of editorial content and Internet infrastructure.
URAC says it has accredited 15 sites and has 40 more under review.
Mari Edlin is a writer based in Mill Valley, Calif.