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This article was originally written for the March 1996 issue of Minnesota Physician (Faughnan J. Web Fever: Internet Resources for Physicians. Minnesota Physician 1996 Mar; 9(12)). I retained copyright, so I've posted a revised version here. It focuses on navigating the Web and make it workable. The article refers to some web sites, their addresses follow below. This page is updated periodically. You may freely print and distribute this article, but please leave my name on it.
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The Internet is full of garbage. It's a waste of time. These common complaints reflect genuine frustration with the Internet and its teething problems. On the other hand, there are netheads, like myself, who claim that the Internet and the World Wide Web are the greatest thing since Gutenberg's printing press. By the year 2020, I'll wager that any person in any free country on earth will have access to the accumulated public knowledge of the human race. These are heady sentiments, but what do they mean for physicians today? How can one begin to "manage" the web? What is the web, anyway?
Many persons are unsure of the meaning of the terms "Internet" and "World Wide Web" (or Web). The Internet is a collection of wires, equipment, and standards that allow machines (and people) to communicate with one another. The Web is a collection of electronic documents, found on computers all over the world, that can be viewed using special software. The Internet connects these (and other) computers, and allows their Web documents to be displayed on your machine at home or work. The software that displays a Web document is called a "browser". Netscape makes the most popular browser for Windows and Macintosh computers. There's a web browser, in one form or another, for just about every computer ever made. Wed documents can present text, images and sound to the viewer. Most importantly, they can be "linked", so that one may "jump" from one Web page to another one half-way across the world.
Over the past few years there has been a very strong trend towards using the World Wide Web as the standard way to present information electronically. Online services and specialized resources are rapidly moving onto the Internet and into the Web. The National Library of Medicine's (NLM) Grateful Med is a good example of a clinical application that's moved to the Web. Grateful Med is a Macintosh or Windows application that enables non-experts to locate journal citation information and other data stored in the NLM's vast MEDLARS (MEDLINE) database. Grateful Med works well, but it's been hard for the NLM to keep up with changes in computer environments. Now Grateful Med is a available to anyone with a web browser. Anyone, on any machine that has a Web browser, will be able to use Grateful Med.
The National Library of Medicine has information about Grateful Med, and links to other medical information, on their HyperDoc Web page. The National Institutes of Health have a web page, and the contents of many clinical guidelines are available there. JAMA, the New England Journal of Medicine, and the British Medical Journal are on the Web. Every professional medical organization, from the AAFP to the AMA has a web site. Corporate health care systems are using the Web to communicate with staff, clinicians, patients, and potential customers. The Web may become a foundation for electronic medical record systems. Individual physicians and patients are creating web pages that provide information from their own unique perspectives. There are thousands of clinically oriented Web pages, and many, many more pages aimed at the public.
Of course, the publication rush isn't limited to clinical domains. Every vendor of computer software has a Web page to provide support and information to customers. General Motors has made tens of thousands of pages of automobile information available to customers via the Web. The Encyclopedia Brittanica, in all of its vastness, is now available on the Web. Many speakers at technical conferences are providing supplementary information via their personal Web pages. The Web has made everyone a publisher, with a current potential audience of over 30 million people. It can cost just a few dollars to publish to the entire Internet using the World Wide Web.
Whew! It's all a bit overwhelming. We want a cup of water, and instead we're at the bottom of Lake Superior. How can it be managed? Where can the physician begin? Clearly, navigating the web one page at a time is not going to work! The answer, of course, is to let someone else do the hard work. No-one would try to find a library book by randomly wandering the Library of Congress. Instead, they would use a subject-oriented library catalog, then find the book based on its library number. The key to using the Web is to learn to use this kind of catalog. In many ways, it's easier than learning to use the library card catalogs of old.
There are three subject-oriented catalog's that physicians may find especially useful. Their addresses, or "URLs", are listed in a separate table. Yahoo is a general catalog which tries to list all Web resources. It has a large medical list as well. The Medical Matrix is oriented towards clinicians, and it uses a structure we're more familiar with. The Virtual Hospital provides a good index, and it also has a comprehensive collection of clinical resources.
Another way to begin attacking the web is to start with a collection of pointers assembled by a knowledgeable person. These are often parts of personal web pages. They are analogous to a reading list assembled by a literary critic. A collection that I've been maintaining for just this purpose is called the 'Family Physician's Starter Bookmarks'.
I'd recommend that most physicians begin with the 'Family Physician's Starter Bookmarks', then move on to the Medical Matrix and powerful search tools like Alta Vista. Alta Vista is astounding. To the user it appears as a simple web page, with an area into which one can type keywords or phrases. Extremely powerful computers compare what you enter to an index of every document available on the public Internet. It takes a while to use Alta Vista well; at first one tends to retrieve tens of thousands of references. With a little practice, and by reading their very clear help files, it's possible to develop quite precise searches. You can practice by finding out about your favorite obscure hobby. (Try searching on skijoring!)
The Web can be a powerful tool, though it takes some time to learn it. On the other hand, it took me a while to learn my way around my small local library thirty years ago. The Web can also be unreliable, though the performance is improving. Web pages come and go, and sometimes a "link" leads nowhere. Often, however, you can locate web pages that have moved by doing an Alta Vista search.
These problems we see now are the cost of being present at a turning point in history. Many of them will improve in the next few years, especially when we have a way to charge users by the amount of Internet capacity they consume, and to charge a small fee for viewing Web based information. Small and large industries will arise to provide clinicians and other professional knowledge users with personalized Web catalogs. We'll pay someone else do all the work of updating our electronic personal library! In the near future, the Internet will become reliable enough to be useful during direct patient care, and web based knowledge commerce will become one of our greatest industries.
John G. Faughnan, M.D. Copyright 1997. This document may be freely copied and distributed.