There also used to be two separate Mayo sites—MayoClinic.com, which focused on providing health information, and MayoClinic.org, which focused on the clinic and its services. They merged into a single site in January, Plumbo said, and there is now a higher level of integration between general health information and information about treatments and services offered by the clinic. Other non-profits are pursuing similar strategies. The Cleveland Clinic’s main website does not accept advertising, but it unveiled a sister site in July 2009, called Cleveland Clinic Health, which does. One health reporter contacted for this review thinks these developments at Mayo and Cleveland Clinic are an indication that nonprofits are not any more “dispassionate” about pushing services than for-profits.
In light of such changes and the many subtle factors that affect a site’s credibility, Stoltz agreed it would be very useful to have some sort of regularly updated database that people could use to evaluate different sites. The closest anyone has come to building such a thing was HealthRatings.org, a creation of Consumer Reports’s WebWatch project that launched in 2005 and evaluated the top twenty health information sites. WebWatch shutdown in 2009 when its grant-derived funding ran out, however, and the ratings are no longer available online.
Thomas Goetz, the executive editor of Wired magazine, who has written extensively about personal health and information technology, said that “it’s easy to scapegoat the pharmaceutical industry” when evaluating sites, arguing that drugs often do help people. He stressed, however, that all information providers should be sensitive to the general public’s propensity for “cyberchondria.” Outlined in a survey performed by Microsoft in 2008, the term describes people’s tendency to gravitate toward the worst-case—and most unlikely—explanations for symptoms (a brain tumor, rather than caffeine withdrawal, in relation to a headache, for example).
Goetz doesn’t think there is an inherent difference between for-profit sites like WebMD and non-profits like Mayo Clinic when it comes to “poking the fear button.” Like former journalist turned PR rep and blogger Brian Reid, Goetz noted that the real fear-mongering comes from places like anti-vaccine sites, which push egregious pseudoscience. The existence of those sites does not negate the need to evaluate more serious and professional health sites, however.
Stoltz pointed out that general information sites like WebMD and Mayo Clinic are often just starting points for health searches, and that sites devoted to specific conditions, such as ACOR.org (the Association of Cancer Online Resources), can be even more helpful. And Goetz, like a number of other journalists contacted for this review, recommended government sites like the National Institutes of Health’s MedlinePlus or the Center for Disease Control’s website, which he said often go overlooked.
“As taxpayers, we’ve spent billions of dollars on the research that informs those sites,” he said, “and it’s unfortunate that not many people got to government sites right off the bat.”
According to Goetz, the takeaway message from a chapter about information technology in his 2010 book, The Decision Tree—Taking Control of Your Health in the New Era of Personalized Medicine, is: “The problem isn’t a lack of information; it’s a lack of a way to process it. The more we understand why we’re likely to go astray, the more we can stop treating our case of the sniffles like it’s the swine flu.”
Yet he doubts that a database like the one created by Consumer Reports would help readers to better filter information. “There is virtually no third-party evaluation of any topic on the Internet,” he said. “Even if someone did a diligent meta-analysis of various health websites, the odds are” that people won’t find it through a run-of-the-mill Google search. Pew’s surveys, which found that people don’t systemically research health, support that notion.
“Most people are not habitual health searchers - a symptom pops up, they search on it; a loved one gets a new diagnosis, they search on it; the First Lady holds a press conference about childhood obesity you get the picture,” Pew’s Susannah Fox, who helped produce the surveys, wrote in an e-mail. “Online health information is a ‘break glass in emergency’ activity for most people.”
As for the news media, while Goetz thinks that more coverage drawing attention to the role of the reader in evaluating the validity and quality of health information is “absolutely needed,” it’s not something journalists tend to do.