When Patients Ask About Online Information On Products And Procedures

By Andrew J. Meyr, DPM and John S. Steinberg, DPM

   For better or for worse, we live in an “As Seen on TV” culture. Often, our patients come to us with their own thoughts and ideas based on a commercial that they saw on late night television, an advertisement from the magazine on an airplane or something that they have “researched” on the Internet.

   We would venture to guess that a week does not go by when a patient comes into your office with a specific question about a newspaper clipping or something that he or she has printed off the World Wide Web.

   In some ways, this vast amount of information readily available to our patients is a blessing. It allows them to become actively involved in their own care with the freedom to ask their own questions on their own time. Of course, it can be a curse in many other ways. Daniel Boorstin noted that “The fog of information can drive out knowledge.” Unfortunately, the quality of the information often does not match its quantity.

   As physicians, we feel it is our duty to provide an assessment of all available information in order to recommend what we feel is the best option for our patients. This has become increasingly difficult as the amount of “available information” expands exponentially. For example, we recently did a Google search on “Diabetic Foot Ulcer Cure” and came up with 437,000 results in 0.22 seconds. The following sites represent a small sample of what we found.


   Diabetic_foot. For those unfamiliar, Wikipedia brands itself as a free online “encyclopedia” in which anyone can log on and edit an entry. It is often the first Internet stop for people with a general question about a specific topic. Wikipedia does have a “Diabetic Foot” page that emphasizes prevention and treatment. Prevention is by “frequent chiropody review” in addition to injury avoidance and good lower extremity hygiene. The antibiotic regimen proposed in the treatment section consists of the combination of flucloxacillin, amoxicillin and metronidazole. In regard to advanced therapies, Wikipedia only references nitric oxide, light therapy and hyperbaric oxygen therapy.

   http://portal.acm.org/citation.cfm?id=1361226. This Web site provides a link to an article published in the International Journal of Telemedicine and Applications.1 It describes outcomes following a pilot program in Denmark to provide expert consultation and evaluation of diabetic foot ulcerations through telemedicine as opposed to direct patient-physician contact.

   According to the article, video consultation occurred between a patient and a visiting nurse at one site, and a diabetic foot expert at a separate site. All parties (physician, visiting nurse, and patient) reported satisfaction with the process and indicated that it was a viable way of performing treatment.

A Closer Look At Product Claims On The Internet

   www.reversegangrene.com. This is a Canadian-based Web site for a company dedicated to “the who, why, when and how of reversing gangrene naturally” through the use of nutrition. This Web site recommends two primary interventions to prevent amputation from gangrene.

   The first is Gangrene Clear-G Formula, which can reportedly help save limbs by: “increasing peripheral nutrient-dense, oxygen-rich and germ-fighting blood flow; providing nourishment; accelerating the inner self-healing effect; and repairing the tissues affected by an insufficient blood supply.” It is a powdered blend of 80 vitamins, minerals, nutrients and phytonutrients mixed into a solution and taken orally two to five times daily.

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