A patient with armfuls of internet data is every doctor's worst nightmare. Conor Pope reports.
The US President George W. Bush last month called for broadband internet access to be made available in "every corner of our country by the year 2007", to enhance healthcare services, particularly in rural areas.
His administration believes such access would enable rural doctors to send medical queries to urban hospitals and receive almost instant diagnosis from wired consultants.
"You hear us talk about making sure healthcare is accessible and affordable," the US president said. "One way to do so is to hook up communities and homes to broadband. It's going to be a really good way for us to make sure the healthcare system works better."
Bush is by no means the first person to express the view that new technology should be more efficiently harnessed to improve access to healthcare.
His utopian view of a networked future is not shared by all, however. It is not uncommon to hear dissenting voices about the negative effect the internet has had on the doctor-patient relationship.
Bush's promise of a seamless synergy between the internet and the healthcare system might have a hint of electioneering about it and it has yet to be definitively established whether the internet has a negative impact on patient care. But what is beyond any doubt is that GPs are increasingly concerned at the level of misapplied knowledge their patients bring with them into the treatment room.
One Dublin-based GP told The Irish Times of patients arriving in his surgery with shopping bags filled with pages printed from the internet detailing new and experimental treatments for their illnesses.
"It's very hard to deal with. I don't really have time to read all the material but I still have to put the patient at ease.
"I think everyone commonly comes across 'heart-sink' patients who have done the dreaded internet search," says another doctor.
She accepts that there is a lot of medical information on the internet which is good but a "huge amount is inaccurately written and not written by professionals. The problem is that most patients cannot discern between accurate sites or not and are unable to filter the information with the correct bias," she says.
"Just think, if you read the information leaflet of any drugs, the potential side effects which are listed would scare anyone off taking the drug... and that leaflet is very carefully written by experts."
While she still believes the internet has a positive role, it has to be used as an aide "in conjunction with the doctor's advice as opposed to instead of the doctor's advice or, as often can happen, as an adversarial tool for their visit to a doctor".
Close to 1.3 million Irish people now have access to the internet. Of these, approximately 27 per cent of women and 17 per cent of men use it regularly to source information about health concerns.
In Europe that number rises to more than a quarter of all internet users, while in the United States the figure is 80 per cent - more than 110 million people - of those with access to the internet use it to find out about medical conditions every month.
The editor of health portal www.irishhealth.com, Fergal Bowers, believes medical practice has nothing to fear from the internet if it is used wisely.
"The internet compliments the role of GPs; it does not usurp them. People getting more information about their health gives them more power and while sometimes GPs are thrown backwards [by a patient's knowledge], there is nothing wrong with people finding out what to expect from an illness. Patients are now more prepared to challenge their doctors and that's a good thing.
"GPs now are able to spend less and less time with their patients and after consultations, patients often have more questions. A reliable site can help fill in the gaps," he says.
Well-resourced and researched websites can also help people who are isolated because of illness or geography to access relevant information anonymously and easily. Bowers stresses that people should avoid sites with uncertain origins.
Irishhealth.com has a team of Irish medical experts writing specifically for more than 60,000 registered users. He says there is little point in Irish patients looking up treatments or procedures from US or Japanese sites because quite often they will not apply here.
Another issue which is of concern to medical practitioners is the ease with which prescription drugs can be bought online.
The Irish Medicines Board (IMB) has seen a significant rise in the number of prescription drugs bought online and shipped into the Republic in recent years.
It is against the law to import prescription medication into the State and the IMB has an enforcement unit dedicated to combating the unauthorised supply of medicinal products including internet supply.
The unit works in close co-operation with other law enforcement agencies including the Garda, customs and excise, environmental health and similar international agencies. The enforcement unit is extremely effective in tracking and impounding drugs bought online and, while prosecutions against suppliers in other countries are notoriously difficult, the IMB liaises with overseas authorities with a view to taking the action against illegal suppliers within their jurisdiction.
While many doctors may wish it were otherwise, the internet is not going away. The Government has accepted this and, as part of its health strategy, it plans to develop a national health site which will provide standardised information on health and healthcare.
It is also proposed that the processing of health entitlements should be available online as far as is practicable.
While the Irish proposals are considerably more modest in scale than the plans set out by Bush, they may, at least in the short term, be a great deal more achievable.