All healthcare professionals are aware that patients flock to the Internet to get information about the disease entity they or a family member is currently experiencing. There is a great deal of excellent evidence-based health information on the internet. There is also a lot of misleading, useless and even dangerous information on the Internet.
Over the years, I have tried many approaches to educating patients as to how to safely surf the Internet for health information. I found one method where you can immediately see the patients’ eyes light up! You know the look; the look of understanding.
This is the winning approach. This is also the approach I explain in my programs for healthcare professionals. Participants in the workshops later tell me the approach was a lifesaver! The approach involves suggesting that patients look at the website’s “ending designation.” Patients need to have a basic understanding of what the different designations mean and how those designations effect the website content.
Explain to patients the four primary website designations and discuss the rationale as to why some designations can be more trusted than others.
- .GOV: The .gov websites are from government organizations. An organization MUST be a government institution to receive this designation. These websites offer top notch information and patients should be encouraged to visit these websites. These websites are unbiased and provide objective information. Government websites also offer information about new research, such as clinical trials.
- .EDU: The .edu websites are from educational institutions. An organization MUST be an educational institution to receive this designation. These websites offer excellent research-based information. Patients will gain vital information from these websites. There is a small caution with these sites; educational institutions are often affiliated with certain hospital systems and may subtlety promote their medical services.
- .ORG: The .org websites are generally used by associations and non-profit organizations. These websites offer wonderful information and are highly recommended. There is a caveat, which is slight, in that anyone could get an .org designation. This does allow for the potential of unscrupulous people putting up quack websites using the .org designation. (With patients, I then review the “Is this a legitimate website?” tip list. See below)
- .COM: The .com is an abbreviation for the word, commercial. Even though there are many wonderful health websites with the .com designation, the potential for abuse is highest among these websites. (With patients, I then review the “Is this a legitimate website?” tip list. See below)
Overall, the .edu, .gov and .org websites are excellent sources of reliable evidence-based health information. Of course, there are many outstanding .com websites; however those types of websites should be reviewed more carefully for a commercial bias.
Is the website selling something?
This is the million dollar question! When talking to patients, I always immediately mention this fact. If a health website is selling a product or service, they will be biased. I always emphasize to patients that this does not mean the product or service is bad; this means the website will not be completely objective.
When talking to patients about internet searches, I provide examples of unbiased versus biased websites. For example, there are two websites with articles on the benefits of physical exercise. One website is a government (.gov) website and the other website is a commercial (.com) website that also sells exercise equipment and herbal remedies. It is obvious the commercial website would be biased in favor of their products.
Is this a legitimate website? Top tips to determine
When patients visit websites, I encourage them to consider the following questions:
- If the researcher is identified, is he/she a professional or accredited authority on the subject? If not, does the author state his/her perspective on the subject? For example, by saying “I’m a patient with diabetes.”
- If an organization is responsible for the information, is it a reputable organization recognized as an authority on the subject? Do they provide evidence of their expertise?
- What kinds of evidence are provided to endorse a specific treatment or service? Keep in mind that scientific studies and research have a different credibility than first-hand experience. One person stating, “This product saved my life!” is not helpful. The research needs to indicate groups of people were helped in controlled scientific studies.
- Does the website provide contact information about the author or organization (for example, full name, address and phone number)?
- Does the organization position itself as the sole source of information on a particular health topic? A legitimate organization would never position itself as the only credible source of information.
- Is the information reviewed and/or updated often enough given the content? Is the date of the last update clearly marked on each item or screen? If information is only valid for a short time, is this fact clearly labeled?
- Are both (or all) sides of the issue presented? If not, does the resource state that it presents only one side of an issue? For example, a site that promotes a vegetarian diet should indicate that there are other dietary options, or clearly state that they are only presenting one side of a multifaceted issue.
- Are commercial links and/or sponsorships clearly stated? Are these sponsorships separate from the health information content?
- Does the website offer a clear statement that the health information presented should not be taken as health advice or a substitute for visiting a healthcare professional?
- Is The Health on the Net (HON) logo present on the site?
The HON logo is a designation from a non-profit, certifying body verifying objective online health information. Of course, the absence of the logo doesn’t mean the site has questionable content.
The strategies in this article will help your patients “surf safely.” There is a great deal excellent health information on the Internet. Our job is help patients follow the right path.
Edward Leigh is founder and director, Center for Healthcare Communication.