Hi April, tossing out my two cents. :-)
April KirkHart wrote:
I just want to make sure we don't miss the point that there is data out
there which shows that information from the Internet can move some people to
actually seek a medical professional's counsel whereas they might not
otherwise. Granted, that has it's pluses and minuses as many medical
professionals know all too well (the Lunestra comment was duly noted).
Consider that the Lunestra comment came from Trinidad and Tobago, which
gets cable television mainly from South America. The television tells me
to ask my doctor about Lunestra. So, playing along I do so - and my
doctor laughs at me and tells me to stop drinking coffee. I like coffee.
I go to the pharmacy and ask for Lunestra, since I can get just about
anything I need from a pharmacy in the region without a prescription.
They don't have any, but they have Ambien. So I buy some Ambien, and I
take the Ambien with some coffee. :-)
Purely speculative, of course, but plausible.
The data that is out there about seeking a medical professional's
counsel... it may not be of use in countries where I can just walk into
a pharmacy and get some Tylenol 3 because I have a headache. :-) If I
have a headache THAT bad, I should probably see a doctor. If that data
is to be used, cultural changes have to be made. I'm sure that the data
is valid in some parts of the world, but that data may have come from
studying global exceptions.
Personally, I like being able to short circuit doctors with minor
things, but I have had some medical training and I also am quite certain
where my medical training ends. In many ways, I'm the poster child of
what people shouldn't do in this context, but I am not alone. I've seen
people go in and buy one penicillin tablet. One. A 10 day supply for any
infection is supposed to be worthwhile. Why did they do that? Probably
word of mouth, not internet access, but what is the difference between
internet access and word of mouth?
So, I'd suggest being careful with that data... I don't think it fits
everywhere.
In addition, Internet access is not only about information, but applications
that can facilitate getting care to some people who don't have access to
health care otherwise and improving quality of care. A number of these
applications have a real impact on health and health care - for example,
enrolling people in public health programs in the U.S., as well as in
disease management from home (children using a web-based program to monitor
and report on asthma from home which reduced asthma-related limits on
activity by 48% compared to a control group - asthma is one of the most
frequent reasons why children miss school).
All of these applications come from the data of the respective country
or region. Getting that data first is very important, and sadly that's
one of the core problems. I am working on something that should help
address that (MAHIN), but it remains a problem and I do not see it
changing over the next 5 years despite what might be considered
individual heroic efforts throughout the region by many medical
professionals. I've been fortunate enough to meet some.
Telemedicine is another example. It relies heavily on broadband
infrastructure and access - and can help get medical care to people who
don't have access to enough physicians or physician specialists in the U.S.
It does not mean that we shouldn't still work on getting more physicians to
those areas, but in some cases, a telemedicine program can help physicians
and other medical professionals from feeling isolated (opportunities for
continued learning, connection to universities and larger hospitals,
connection to colleagues and mentoring, etc.) which may make living and
working in more remote areas more attractive.
I think *this* is the biggest thing. And I think that this can help
accumulate more appropriate data for regions.
I just didn't want us to miss out on the ways that technology and Internet
access to increase contact with and between medical professionals. AND you
are absolutely right to make sure that we don't forget that in-person human
contact is so very important for healing and health.
Thank you for making sure that didn't get lost in this conversation.
I always get scared in conversations like this. I really do. It's an
awful responsibility that many people remain ignorant of, or forget when
dealing with statistics... One of these days, I'll shuffle off to become
a statistic and I worry that someone might put me in the wrong stack. :-)
--
Taran Rampersad
Presently in: San Fernando, Trinidad and Tobago
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