Kitemarks won't cure 'Cyberchondriacs'

My first experience of "internet print out syndrome" was in a suburban general practitioner's surgery. The syndrome seemed to affect essentially healthy people who wanted to go to the doctor to have a lengthy discussion about minor symptoms. Perhaps they had undergone early retirement and were now so bored that they were desperate to have an excuse to chat with a doctor. And if they got a prescription out of it, that was a bonus-they got a chat with a pharmacist too. These "cyberchondriacs" tended to be financially comfortable enough to believe that good health was worth paying for.

We all know how amazing the internet is and how it has allowed wider possibilities and better communication. And we know with these advances come a few specific dangers: misinformation is definitely one of them. "Don't believe everything you read in the papers," as the maxim says. This scepticism of even the more distinguished newspapers remains in spite of the strict laws that surround what can and cannot be printed. And yet credit is given to information published on websites-part of a patient's "research." The information held online is so vast that, unlike for printed media, it cannot be policed.

But websites about health serve a purpose. For example, search for the words "cancer", "HIV/AIDS", or "Alzheimer's" and you get a list of organisations, self help groups, or trials looking for patients. However, try "depression", "indigestion", or "eczema" and adverts for guaranteed cures or pharmaceutical companies' home pages come top of the list. Organisations that push drugs are currently forbidden from directly advertising to the public everywhere except in the United States and New Zealand. But this is easily bypassed on the web.

Medicine is about probability. A patient will present to their general practitioner with a new symptom that they have developed which may leave them quite frightened. The doctor will opt for the most likely diagnosis. When the same patient self diagnoses on the web, he will tend towards the more serious options, however unlikely.

Information on the internet cannot be regulated. Paul Cundy, general practitioner and chairman of the BMA's IT committee agrees: "Kite marking is impossible. There is no way it would work. People can forge or copy a kite mark so easily."

Websites have no responsibility to the patient, whereas the doctor does. Often sites will be written by someone not medically trained or, even worse, a public relations officer, and give biased view points with sensational true life stories. This can fuel a patient's anxiety that no amount of web surfing will cure. Overworked general practitioners may approve of their patients using the internet to keep up to date with their chronic condition, but going through a flowchart on the NHS direct website will never be a substitute for a history and examination.