The widespread availability of medical information on the internet and its effects on health care has exponentially increased over the past decade. Several studies have reported an increasing proportion of the public using the internet for health information.10,11,12
However, information about internet use by the medical community is not well studied. This is the first physician based survey attempted to assess and correlate the extent of internet use among a heterogeneous cross section of healthcare professionals. These data will have substantial implications on health care as the internet emerges at the intersection of medical informatics and public health. We found strong evidence of an increasing use of the internet by physicians and other allied healthcare professionals.
Lack of access to the internet may be a barrier to wider use of online sources of health information.19
This is valid for patients as well as physicians in many aspects. Unfortunately, this facet has never been addressed in the literature. Our study concluded that almost 98% of the clinicians have internet access, with 72% accessing both at work and home. This interest seems to be extending to the willingness to take certified web based CME courses through a web site, with 82% of respondents showing such an interest.
Bates et al16
concluded that on average, each ambulatory visit generates one clinical question that the physician is unable to answer. Instantly accessible, up to date evidence based data should be a standard feature in medical practice. Healthcare professionals conduct millions of Medline searches each year for professional updating17
and our study reiterated this fact with 72% of respondents reporting using the internet regularly for medical and professional updating. None the less, many users find electronic searches to be unproductive and time consuming20
without high speed connections (DSL/Cable/LAN, Broadband/ISDN). There is a significant increase in high speed internet service providers (ISP) emerging in the market along with the consumers using high speed internet. Our study also shows similar results, with 75% of respondents using high speed connections.
Secure, personal practice web pages represent a more comprehensive form of electronic communication between physicians and patients. These can serve multiple purposes, including being a channel of communication, creating a list of diagnoses, drugs, and preventive services, and offering appointment reminders.13,14
Statistics relating to the use and development of personal practice web sites by physicians are completely lacking. The results of our study show that 27% of physicians currently own established personal practice web sites. This reiterates the fact that most healthcare professionals believe that owning a web site would be beneficial to the patients as well as to their practice. Sixty two per cent of the survey respondents would allow patients to access their information through a web site, and slightly more than half of the survey respondents favoured second opinions via the web as a valuable resource for patients. This matches with the survey data by Murray et al21
where patients whose physicians encouraged them to look for information were 58% more likely to talk to their physicians about the information on the internet, as compared with 42% whose physicians did not encourage them to do so.
Electronic interactions provide email communication between provider and patient, inform patients of test results, arrange referrals, and create an improved continuity of care. This avoids difficult scheduling patterns seen in most hospitals. Our study shows that more than 70% of healthcare professionals approve of these beneficial effects of web communication, while only 6%15
of the public use email options to reach their physician. About 20% of adults in the USA use the internet to access health information.18
Holding contrasting views, 53% of users are distrustful of information they find on the internet, as compared with 27% of the physician counterpart we surveyed. More than 70%19
of patients report that internet information influences healthcare decisions, as compared with 51% of the professionals we surveyed.
To establish a heterogeneous sample with a mixture of physicians and other healthcare professionals, we chose to distribute our survey at a variety of seminars, instead of sending questionnaires to physicians from different clinics. The use of a convenience sample is a drawback in our study as health professionals coming to educational sessions are not likely to be representative of the population. As many previous studies17,18,19
have reported the trends in web based medical resources for patients, our objective was limited to study the extent of internet use among physicians. Although we randomly chose seven seminars/symposiums, we did not randomly choose the participants to these seminars. For this reason, it was essential to see which seminars/symposiums had a high percentage of respondents, and of those respondents, who used internet resources for their research and patient care. Our surveyed group was not limited to any particular discipline, but the group was varied in an attempt to achieve a heterogeneous representative sample. Although physicians from all over the USA attend these seminars, a significant number of the participants were from our organisation, creating a biased source.
A total of 66 surveys were eliminated from analysis to address the context of missing data (incomplete surveys) in a conservative way. A trend in missing data was not carried out in this study. The p value of the main outcome (p<0.002) indicates significant power to support and justify the results. The important strength of this study lies in its broad inclusion of disciplines in a randomised fashion with a high response rate, and its statistical correlation. With a 64.8% and 96.9% increase in physician and non‐physician participation in ACCME accredited activities in the USA since 1998,22
our survey data have a high impact factor.
This study adds to the literature by describing the physicians' perspective on the evolving internet environment and experience with patients who have sought internet health information. Online communication and internet based interactive web sites lay a strong foundation for patient care. Although the internet is a widely used source of health information in the 21st century, data on accurate estimates of suitability and adaptability, especially within the medical community, are needed. Our study shows that internet use and web based medical information is widely popular among healthcare professionals.