Thursday, May 21, 2009

Can social networking on the internet improve your health?

We have all heard the term Web 2.0. It refers to a second generation of websites and activities mainly involving social networking websites like MySpace and FaceBook. A related recent term is Health 2.0 which is the use of Web 2.0 methods for healthcare. There has already been one excellent Health 2.0 conference that was widely attended by industry, health providers and some patients, and another such conference is occurring soon in San Francisco. The whole concept of Health 2.0 and the use of social networking sites in healthcare is starting to gain momentum, and the increase in interest in what is being called "participatory medicine", where patients and health providers collaborate more equally than in the past, is likely to give it more of a boost.

Much of the history of these types of initiatives can be traced back to Dr Tom Ferguson, who was one of the giants of the early years of the Internet. He urged patients to educate themselves and share knowledge with one another, and encouraged doctors to collaborate with patients rather than command them. Predicting the Internet's potential for disseminating medical information long before it became a familiar conduit, he was an early proponent of its use, terming laymen who did so "e-patients." He classified doctor’s consultation styles on the net into two types. He talked about Type 1 doctors who are "advisors, coaches and information providers" but who specifically do not attempt to diagnose or treat. These doctors, or other health professionals, are typically available through their own sites, or through the many commercial sites. They generally don't advise the same patient twice, usually don't even give their name, although the commercial sites "guarantee" that they are fully qualified, and will often refer you to a local face to face doctor or hospital. Interestingly, I understand, this is how many of them receive payment for their services - the sites get a "spotters fee" from local services that they refer to.

Ferguson also defined type 2 doctors, the majority of medical providers on the net. These are doctors like me who provide normal face to face care, and who encourage their patients to also use email to contact them directly - a rational and sensible use of new technologies which, as long as guidelines for Internet consultations are followed, is a great way of working for both patient and doctor.

Full time Internet health services and providers will become much more common in the next few years, however, as we move to being able to use secure video systems over the Internet. I predict that eventually as many as 10-20% of all health consultations will take place in cyberspace within 10 years or so. This will be a real revolution in healthcare.

I do think that the emergence of online doctors who are prepared to treat their patients in a collaborative manner, both face to face and online, is the way of the future. The question is, how will this happen, and can it happen via social networking sites on the internet? I think this will be perfectly possible. There is no reason, for example, why groups of patients, along with their doctors, could not sign up for a "closed" social networking site that focused on their particular chronic disease, say diabetes, heart disease or depression. The social networking site could allow all patients to access many different doctors for advice and health education, and could be supplemented by educational information recommended by both doctors and patients who are members of the site. This is effectively the same as facebook, where "friends" are accepted into a social networking group, and not just anyone can join. The disease focused networking site, and all its activities, would occur as an adjunct to the patients having their own individual continuing doctor-patient relationships with their usual doctor, whether this relationship be face to face and/or online. I think it is time for some research in this area to see if this combination of conventional care, and social networking support, can actually improve patient outcomes in the long term. My bet is that it would.

This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at and most online bookstores. A shortened version of the book, available as an e-Book for download to iPhones, Blackberry's, PDA's and other mobile devices called "4 simple steps to better health - an insiders look" is available at Smashwords at

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