Arthritis and the Internet by Dr David Gotlieb.
 drdoc on-line

   

The world has changed.
It is becoming smaller.
Whilst borders exist between nations, communications have broken down barriers, and the gaps that separate us are just a phone call away.
We are now able to research and acquire knowledge beyond our expectations and dreams. Because of the massive linking and networking of computers, people are able to write and be read, by millions of others worldwide, in an instant.
With this has come the capacity for the ordinary man or woman in the street to research anything and everything possibly imaginable. All that is required is a simple computer and communication device, a modem, connected to a telephone line.
Somewhere out there for various reasons, people with expertise or personal opinion, have recorded their knowledge on computers in a way that is accessible by all who connect to the web of information, now known to all as the internet.
The Internet has allowed browsing to infinite computer sites worldwide. The network of sites is known as the World Wide Web (“WWW”).
In fact, the Internet is more than just a web.
It has enabled communication through electronic mail between individuals or groups in a format known as email.
It has allowed groups of people with common discussion points to meet in “chat rooms” and newsgroups.
It has allowed transfer of information and data with a click of a button.
It has almost infinite power.
This includes both positive and negative aspects, but the balance is undoubtedly beneficial to the world at large.

Precautions


Don’t believe everything you read.

Regard medical information with caution.
Discuss your findings with your doctor.
Do not change your therapies unilaterally.

Don’t give out personal details to everyone you meet on the Internet
Do not give out your credit card information, unless you are sure whom you are dealing with and that the process is secure.

Software on-line


Software is easily available and usually free on the Internet.
Several basic requirements are suggested before downloading software programs. The main requirement is a good antiviral package to prevent damage to your own computer by malicious programmers, who insert and activate their computer code when you execute their programs. This can be done entirely without your knowledge and disseminated by you every time you send information such as email or programs to others.

I suggest that you buy either Norton antivirus, or McAfee antivirus, and keep them updated by downloading updates on-line.

 Software sites

www.download.com
www.tucows.com

The net is expanding every day.
There are now over 2 billion web-pages, increasing at 7 million per day, and is likely to double within 2 years.
However, this clearly produces problems. It is increasingly difficult to access ‘good’ information. How does one sort out the poorer quality website, from the sites with good information. It must be noted, that if the public cannot find a particular site, then no matter how good it is, it may as well not exist. The search for information returns hundreds of thousands of response. As a result one needs to sift out the ‘deadwood amongst the trees’.
There are no limits who can put information on the web. There are no standards, and no controls whatsoever. Therefore, many parents have been alarmed about access of minor children to the web. However good far outweighs the bad, but one requires to be critical about one reads, bearing in mind that it represents an opinion, and not always fact.
This applies especially in the field of medicine, as people are bombarded with claims of cures and magical remedies. Beware of the trap. Many people prey on the sick for financial gain.

Good general search engines


Yahoo:              www.yahoo.com
Excite:              www.excite.com
Webcrawler:       www.webcrawler.com
Alta vista:           www.altavista.com
Ask Jeeves:       www.askjeeves.com

Good medical reference medline sites

Healthgate: http://www.healthgate.com/medline/search-medline.shtml

NIH: http://www.ncbi.nlm.nih.gov/pubmed/

It is a recommendation that you write your search criteria as simply as possible. For example, “rheumatoid arthritis and the lung” or “methotrexate and rheumatoid arthritis”. Avoid using capital letters.


Several general “do’s and don’ts are advised.

The medical field has lay and professional websites and information available. Both may be highly unreliable, and caution is required in using the information. Medical websites may in addition be too complex, but once the public gets used to the Internet and understands it, then the process gets much easier.

A number of good general search engines are available to search for information. These include, Excite, Yahoo, WebCrawler, Infoseek, but programs are available for download that will integrate all of these in one search function. My favourite is to download and install a program called copernic, located at www.copernic.com .

Professional medical literature searching is now easy. In the past, what took a doctor weeks to research, is now available online in minutes. There are several search engines for medical articles. My favourite is healthgate. However the American national institute of health offers huge medical reference search engines.

There is no harm in the general public researching their disease, although clearly this information, for the lay public, is likely to be difficult to understand.

The truth is that using the huge amount of information becomes much easier the more you make use of it. Everyone finds great sites, and it is advisable that you add these to your “web-browser favourites”

But what about meeting others online?

There are many support groups out there who are forming “web communities”. Many are available on a free subscriber or registration basis, such as the Microsoft network, or on America on-line. But the most accessible support groups are on the Internet newsgroups. There are two main arthritis Internet newsgroups. These are misc.health.arthritis and alt.support.arthritis

The newsgroups are accessible from your browser or email program and the requirements to access the newsgroups can be simply obtained from your Internet service provider who will guide you how to do this at no charge within minutes. The process is similar to how you set up your email addresses to access email.

On the newsgroup, people place messages and these are readable by all, and answerable by all who visit that particular newsgroup. Hence any question will result in responses from many people who have had that experience and can give appropriate advice. However, again the responses are opinions and not necessarily fact, and therefore should be treated with caution, and discussed with your doctor.

Essential links to information on rheumatology:


Societies and foundations.

1. American college of rheumatology
http://www.rheumatology.org

2. Arthritis foundation USA
 
http://www.arthritis.org

3. Arthritis Society Canada
 http://www.arthritis.ca

4. Ankylosing spondylitis society
 http://www.spondylitis.org

5.Osteoporosis foundation
 
http://www.nof.org

6. Lupus association
 
http://www.lupus.org

7. Psoriasis association
http://www.psoriasis.org

Patient based websites / Public arthritis websites:

1. The arthritis pages of drdoc on-line
 
http://www.arthritis.co.za

2. Arthritis at about.com
 
http://arthritis.about.com/health/arthritis/

Other interesting resources

1. The arthritis better living spa
 
http://www.arthritisconnection.com

2. National institute of health USA
 
http://www.nih.gov/health/

3. Int’l league of association of rheumatology
 
http://www.ilar.org

Newsgroups

1.  Misc.health.arthritis

2.   Alt.support.arthritis

In South Africa, most doctors are now confronted by a host of Internet documents. The practitioner should not see this as a threat, and most do not. However, the public should appreciate that the doctor has limited time, and cannot read everything. A short summary of the questions you want to pose is appropriate rather than placing reams and reams of notes on the desk. I personally encourage my patients to read and research their problem. There is no harm in obtaining a second opinion, and there is no such thing as a stupid question. As practitioners, it is our obligation to answer the concerns of our patients. The Internet represents an enormous opportunity for the practitioner. It keeps the doctor up-to-date, as we now have to be able to answer the latest information, so it is incumbent on the doctor to be as interested as the patient in continuing medical education. Patient empowerment must be encouraged, and the Internet has revolutionized this. 
In my own personal experience, I have found that ¾ of my patients have either direct or indirect access to the Internet, either through home, work or relatives on-line.
The World Wide Web is expanding and getting faster and more accessible to all. 

I strongly recommend people to research their own disease and to ask questions.

What makes a site a good site?

Content – preferably original, relevant and up to date.
Reliability of source and established bona fides / references.
No claims of cure, guarantees or false promises
No demands for money for information
Stimulating presentation – but remember – content is king.

A table of some of my favourite arthritis links is included here.
There are too many to list, so only a key few are listed. Enjoy your web browsing.
And finally, again, always remember:

There is no such thing as a stupid question.

Background to the drdoc on-line website


Computers have always been my main hobby and I first became connected to the Internet in 1996. The medium allowed a natural combination of my love of Rheumatology, and my passion for computers and medical graphics.

One of the first things that I did was to become active in on-line interaction with and between patients on the Internet newsgroups.

 I became the rheumatologist on-line, consulting on the newsgroups and responding to email questions around the world. Because of the volumes of questions, many of which were repetitive, I started my own website in 1997. The aim was to provide the lay public with information that was practical, readable, understandable, and that answered every question out there related to arthritis. The articles and website design were all written and organised by myself. This grew to a large and busy site, all done after hours, at no cost.

The website currently is one of the largest websites in the world on arthritis, and has won several awards. It was the top website on the SAWebchart for several months and is still in the top 10. It received the Mail and Guardian newspaper award for top physician website in 1998. It was featured in an Internet symposium at the American College of Rheumatology annual meeting in Washington in 1997, and was in fact the only physician site demonstrated at that meeting.

The website receives thousands of visitors, and now has approximately 38000 page impressions (one of the largest of its kind WORLDWIDE) per month. It is unique as a resource of its kind, in arthritis.

Letters stemming from the newsgroups now approximate 30 per day, all answered at no cost and all researched from on-line sources, as required.

The only limitation is time, since I still maintain an active full time rheumatology practice

 

 

 

Dr David Gotlieb
Rheumatologist
Constantiaberg Medi-Clinic
drdoc on-line
November 2000

 


 
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