REQUESTS FOR MEDICAL ADVICE FROM PATIENTS AND FAMILIES TO HEALTH-CAREPROVIDERS WHO PUBLISH ON THE WORLD-WIDE-WEB

Background: The Internet is a novel, rapidly growing means of worldwid e public communication. Methods: We reviewed all unsolicited electroni c mail and other communications from nonmedical individuals requesting medical information over a 12-month period from the physician at 1 es tablished site on the World Wide Web. This site was the only Internet site with a primary focus on cardiac arrhythmias. Results: Seventy uns olicited inquiries were received from 39 patients and 20 family member s (the sources of 11 inquiries are unknown) from 20 states, Washington , DC, and 9 foreign countries (locations of 15 inquiries are unknown). Follow-up was obtained in 22 cases. The inquiries concerned cardiolog ical conditions in 67 cases (96%) and cardiac electrophysiologic condi tions and procedures in 52 cases (75%). The goals of the inquiries wer e diagnosis (15), therapy (48), prognosis (1), and patient education ( 6). On follow-up of 22 cases, the people initialing the inquiries stat ed that they were reassured (16), consulted a general cardiologist (1) , consulted a cardiac electrophysiologist (4), or visited a tertiary c are electrophysiology center (1). Conclusions: The increasing use of t he Internet by the general public seeking specific medical information for themselves and for their families suggests a widespread, unmet ne ed for objective medical advice. This study demonstrates that the publ ic can choose accurately whom to ask for subspecialty advice in the ar ea of cardiovascular diseases. Professional societies and regulatory a gencies should develop physician guidelines for providing medical advi ce over the Internet.