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Doctor on Call: Your Guide to Online Healthcare

Getting Health Information Online

About five months ago, I woke up with a tickle in my throat. I didn't feel sick and my temperature was normal, but every time I swallowed, it felt as if a grain of sand were stuck somewhere near my tonsils. I looked in the mirror and said aah -- and to my surprise, I saw a row of six bumps on the back of my tongue.

I freaked.

Thought number one: I had contracted some bizarre STD of the mouth (even though I was in a long-term monogamous relationship). Thought number two: Oh my gosh, it must be throat cancer (although I hadn't touched a cigarette in ages).

I canceled my date with the stairclimber and headed straight for my computer, where I typed "bumps on tongue" into Google. I jabbed "enter" and 934,000 Web pages popped up. After clicking through message boards on which similarly freaked-out people had written in about the exact same problem, this is what I learned. According to the Internet, I had enlarged circumvallate papillae taste buds, a term used to describe bumps that form a small V where your tongue meets your throat and apparently swell from time to time for no good reason. I double-checked in the mirror to make certain that mine formed a V, and sure enough, they did. My heartbeat slowed and I decided I'd make it to the gym after all (and that I didn't have to waste my time or money on a doctor's appointment).

According to a study by Manhattan Research, a drug and healthcare market-research company, 145.7 million Americans went online in 2008 for health-related reasons, and 70 percent of those surfers consulted the Internet for health information at least monthly.

Now the Web is expanding into new terrain: assessing not only your potential illnesses but also the physicians you pay to prescribe a cure. Just a few clicks and you're able to uncover some decent dirt on your doc -- his med-school track record, papers published, comments from peers. But as with online health advice, knowing which sites are reputable and which are based on rumor is key.

Finding the Right Doctor Online

Rule number one: Beware of biased sources. Many insurance companies won't list doctors who are out of their networks; online phone directories are often paid for by ads from the physicians they feature. Your better bet? "Start by going to the site for your state's licensing board, where you will see a listing of every person who has a legal right to practice medicine there," says David Donnersberger, MD, an assistant professor of medical law at Northwestern University, internist, and attorney. "Also, you should check to make sure any doctors you might go to are board-certified, meaning they have passed a battery of tests and meet the minimum requirements that allow them to specialize in a certain area of medicine."

Never having checked out my own doc online, I was curious. I went to medicalboard.georgia.gov and typed in the last name of my physician in Atlanta. The Web site informed me that his license was up-to-date (though I discovered there was another doctor in that city with the same last name who had let his expire). Next, I wanted to verify my MD's board certification. I typed in www.abms.org for the American Board of Medical Specialties and registered by entering my e-mail and creating a password (there's no charge). Then I typed in my doctor's name and city and happily confirmed that he's a certified generalist in my state -- not that I was surprised, but it was still nice to know I hadn't been seeing some quack for the past five years.

I was interested to find out what more subjective Web sites -- like the ones where patients rate the doctors they've seen -- would say about my physician. But previous experience with the unreliable nature of sites on which other customers recommend hotels or movies they like made me hesitant -- for good reason, as it turns out. "If a Web site wants you to enter detailed demographic data before sharing any information, that's a red flag -- be wary," Dr. Donnersberger says. "Those are typically profit-making sites that will offer you only the doctor's name and address, which you can get for free anyway from the Yellow Pages. Then they'll start suggesting unrelated services [like personal trainers and health spas] in your area, because those companies are paying them."

I started my search with vitals.com, a free site that provides information and credentials for more than 700,000 active U.S. doctors and also allows you to search by symptom so you can locate experts who specialize in your condition. I found my physician's name, next to which it said he was board-certified (knew that!) and that he'd gone to a top-notch medical school. His photo popped up, as well as his address, phone number, and hospital affiliation, but no patient had rated him yet. So I did, filling out a survey that scored him from poor to excellent on a number of factors, including bedside manner, waiting-room time, ease of getting an appointment, and his follow-up after the visit. Now his patient rating is four stars (the best), thanks to me.

But what I really wanted to know was what other people thought, so I tried a different site: healthgrades.com. For $12.95, the site offers patient reviews, a background check, and the scoop on any malpractice suits. But I was looking for something that was free, so I declined.

Another site, ratemds.com, came up high on the search engine I used, so I checked it out. Ratemds.com boasts a database of more than 150,000 doctors, largely assembled from reader reviews. Pay dirt! My doctor had been rated by his patients. His score? An emoticon smiley face -- code for punctual, helpful, and knowledgeable.

I happened to agree with this rating, but given the nature of consumer-driven Web sites, it's best to use the information for general guidance (although anyone with consistently poor ratings should probably be avoided) and save the final judgment for your own experience. "A lot of patients who actually take the time to write reviews are going to be disgruntled," Dr. Donnersberger points out. "As in any business, you rarely hear from the happy consumers."

Keeping Your Health Records Online

Once you've found the right doc, you can use the Internet to expedite the care you get by keeping your health records and a journal of your daily health and fitness routine online and updating them regularly.

"There are major benefits to recording and reviewing your health habits," says Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions, a research company that studies healthcare trends. People tend to stick to a plan when they record their day-to-day regimen, he points out, whether it's detailing a workout session, what they eat, or which pills they've taken. "It's part of the notion that if you go to the trouble of writing down how you treat your body, you tend to make more right choices for yourself."

In addition, Keckley says, "research suggests that people who use online records are more likely to be their own advocate when talking to their doctor about treatments. By having access to their files, they learn more about their condition and are better informed." Currently, 38 percent of doctors' offices use electronic health records, up 10 percent from three years ago.

So where do you go to start creating your own? Most major insurance companies are developing tools on their Web sites that will help customers organize medical information electronically. Alternatively, if your doctor does keep e-files, ask for a link and password to your records that allows you to have all your test results, past hospital visits, pharmacy information, and administrative records at your fingertips.

Another option: Web sites that let you maintain your own records. "Some companies, like Microsoft, have free software you can download to organize your health information," Keckley says. You can also go to myPHR.com, a free site sponsored by the American Health Information Management Association, a nonprofit health-advocacy group, and follow a step-by-step process for creating an e-record.

The most important step is protecting your personal information. "Start with your own computer and network," says Robert Siciliano, founder and CEO of IDTheftSecurity.com in Boston. "Make sure your virus protection, spyware removal, and firewalls are all running properly and are up-to-date." Most programs will automatically update information when you start up your computer, but you can also periodically check the home pages for whichever brands you use to see if there are any new software packages. If you're on a wireless connection, create a password (you'll be prompted by your computer when you set up the router). "Use a mix of uppercase and lowercase letters as well as numbers -- this makes it less likely to be hacked," Siciliano says.

The bottom line: Online medical records is the way of the future. And though software companies are constantly improving their security programs, it's ultimately up to you to be sure your information is safe. "It's the people who say, 'It can't happen to me' that worry me most," Siciliano says. "Because, I promise you, if you don't stay current with your software protection, it can and it will happen to you."

The Best Web Sites for Managing Your Health

Start Here for Fast Relief

These Web sites make managing your health easier than ever.

ZocDoc.com

In the New York City area (with plans to expand), ZocDoc lets you make appointments with doctors or dentists just by going online. Like OpenTable.com for foodies, it allows you to create "reservations" with a doctor and take advantage of last-minute cancellations.

Americanwell.com

Launched in the summer of 2008, American Well offers virtual doctor visits -- the ability to talk with a clinician, even a specialist, in real time, 24 hours a day. Blue Cross Blue Shield of Hawaii was the first to pick up the service; in early 2009, other major insurance companies are expected to offer it as well.

iMedix.com

Like Facebook for healthcare, iMedix is a community-based Web site that allows you to create a profile and add whatever health issues interest you. Then you can chat with other members who share the same concerns. Is it normal to have bad monthly cramps at age 30? Are there any great home remedies for fighting a migraine? Post your question and be prepared for answers, stat.

Healia.com

This consumer-health search engine lets you narrow your inquiries with a filter to find clinical trials related to a topic that interests you, as well as the latest studies in academic journals.

Originally published in FITNESS magazine, March 2009.

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