The Patient's Internet Handbook
Authors: Imogen Evans
Journal: Journal of the Royal Society of Medicine (2002)

Richard Asher, delivering a lecture on medical education of the patient and the public in 1959, noted wryly ‘...the public must be given some medical education because they demand it... if we as doctors don't tell them anything they will invent explanations of their own, or they will ask their grandmother, or they will go and ask the local chemist. They will pick up myths and legends which may be harmful’. Over 40 years later, few would deny that grannie, if not the pharmacist, is undoubtedly being eclipsed by the Internet. More than a third of UK households can access the web and the figure is rising steadily.

But health information on the Internet is not necessarily reliable either. Hence the British Medical Association's advice on Internet medicine, which includes: ‘always seek a balanced view. Never rely on information from just one source; check out the site's policy on privacy and confidentiality; be wary of anyone claiming to have “miracle cures”, and avoid online consultations and diagnosis’. Sentiments, and more, that are likewise emphasized in The Patient's Internet Handbook. The purpose of this impressively clear guide by Robert Kiley and Elizabeth Graham, of the Wellcome Library for the History and Understanding of Medicine, is to introduce readers to the plethora of medical information on the Internet and to explain, by way of examples, how to satisfy their specific needs. All with the admonition that information found on the Internet should be brought to the consulting room where it can be fully discussed and evaluated.

Before launching into sources of information, Kiley and Graham provide what amounts to a crash course on Internet basics—a masterly account of connecting, browsing and searching. There are major sections on NHS services, drug information, complementary medicine, and pregnancy, childbirth, and infant care, and thorough discussions on quality of Internet information and how to use the information gleaned effectively during a consultation. And finally they focus on 100 selected medical conditions. Not surprisingly, it doesn't end there—readers are encouraged to check the book's own website to question the authors, to make suggestions for future coverage, and to access many of the sites mentioned in the text.

The web is a world of extremes: for example, on cancer alone a wealth of evidence-based data from major research and patient organizations vies with unsubstantiated claims that cancer can be cured by electrical zappers that eliminate causal parasites, or prevented by apricot seeds. Prospective parents can devise a birth plan, receive balanced information about caesarean section, get help with naming the baby, and delve into a series of old wives' tales about sex determination. And what of the future—say, online consultations? ‘About as abnormal a consultation as you can imagine’ according to the BMA; Kiley and Graham caution about the duty of care that such services can provide. Yet in the week beginning 8 January 2002, E-Med, the first UK online GP service, treated its 15 000th patient. The Internet has already changed the way we live; The Patient's Internet Handbook surely warrants many more editions.