CONTENTS

EDITORIAL

NEWS

REVIEWS

VIEWS & POSITIONS

EVENTS DIARY

Issue 4, March 1998

ISSN 1368-1591

Time to reflect

With this fourth Issue my term as Editor of SIM Quarterly ends. As I look back, I am aware of an ever-present enthusiasm for the potential utility of the Internet in medicine. Many of us have put forward a vision of something that would revolutionise the way that we learn, communicate, and even think. But now, like the dinosaur-breeding scientists in Spielberg's film Jurassic Park, we must consider again whether or not we were so busy wondering if we could, but didn't stop long enough to ask if we should.

This question is, of course, equally relevant to many of today's innovations. Innovation is born out of dreams, and there is no shortage of dreamers when it comes to the Internet. The dreamers, however, are in the minority. Most of those in health care have no knowledge - and no interest - in using the Internet in the ways in which the dreamers imagine they might.

A key issue in presenting the Internet to the medical user is in providing an indisputable incentive to use it. Many people find it difficult to see beyond their immediate workload, and the ramblings of an enthusiast can appear to be of little relevance. In essence, we want our jobs to be easier, to spend less time on paperwork, and more time doing the sorts of things we dreamt we might spend time doing when we were training. So if the Internet provides no overwhelming advantage over the telephone or a trip to the library, then we are not overly excited by the idea. Medical people (in particular) tend to be a bit conservative in the way they do things. Modern medicine, we believe, has arrived at 'The Way to Communicate'. Why change? Have we been deluded all this time into thinking that we were doing a reasonable job out there, grabbing disease by the horns and wrestling it into the shape of a paper-based practice?

Maybe. The Internet deserves a fair hearing. We have seen it, in the pages of SIM Quarterly and the presentations of MEDNET, being utilised for education, clinical care, medical research, and of course, communication. The theoretical advantages are many. But consider how usable it is today. It is still far from easy to locate truly valuable, trusted, information (although catalogues like OMNI are a step in the right direction). Connections - especially dial-up modem connections - are so often unbearably slow and unreliable. The battle for dominance of the browser market has ended the 'universal experience' that underlay the development of the Web, as volleys of new features lay waste to less capable computers. There are no widely recognised standards for quality of information. We are concerned about the confidentiality of patient data, subject to increasing amounts of spam, and wary of the dangers of giving medical advice online to unseen (or perhaps unreal) patients. All of these things conspire to make us shy away from the Internet as an everyday technology in medicine.

In my more cynical moments, I am of the opinion that the vision many of us hold of the Internet's place in medicine will not materialise. Not through deficiencies in technology, but because the attraction to end users just isn't there. Having lectured to many medical and paramedical audiences on this topic over the last few years, I am almost invariably challenged by an audience who would 'rather pick up the telephone', or 'finger a journal'. Perhaps this says something about my lecturing skills; I suspect it is more a reflection of the level of skepticism in the real world. A level that perhaps those of us who are enthusiasts have tended to underestimate. So once again, we can, but should we?

I remind myself once more that the Internet in medicine deserves a fair hearing. As enthusiasts we should resist uninformed criticism, but should welcome considered feedback. Let us continue to dream, for dreams undreamed can never become reality. I wish SIM Quarterly well as it carries forward those dreams in the hands of a new Editor.

Society for the Internet in Medicine

Comments to: simq@cybertas.demon.co.uk

Copyright © 1998 Society for the Internet in Medicine. All rights reserved.
Date: March 1, 1998
Document URL: http://www.cybertas.demon.co.uk/simq/issue4/editorial.html