The New Patient Power

All kinds of drugs are available on the Internet, some of them efficacious, some of them not. The most popular are the so-called "lifestyle drugs," such as Viagra (for sexual dysfunction), Propecia (hair loss) and Xenical (weight loss). Online sales of prescription drugs can be quite legal if the doctors writing the prescriptions are licensed to practice in the states where the purchasers live, and if the pharmacies are licensed to dispense them there. In the past year many questionable vendors have moved out of the United States to Web sites based offshore. U.S. Customs can seize illegal shipments, but many get through. Purchasers have no guarantee that the drugs aren't counterfeit or the wrong strength. And even a genuine drug can be dangerous to some users. Last summer an Illinois man named Robert McCutcheon, 52, died of a heart attack after taking Viagra and having sex three times with his girlfriend. He had bought the drug, without a prescription, from a now-defunct Web site. If McCutcheon had gone to a physician, his coronary artery disease might have ruled him out for a Viagra prescription.

Despite the risks, patient power can only increase in the years ahead, as information technology improves and more people learn how to use it. Pressures for cost containment and demands on doctors' time aren't going to ease up, leaving patients with both the opportunity and the need to monitor their own care. "The potential benefits far outweigh the potential harm," argues George Annas, chair of the health law department at Boston University and author of "The Rights of Patients." An informed patient and a receptive doctor can have a productive collaboration. It won't be as cozy as the old doctor-patient relationship, but it could be better medicine.

Use Caution on THE WEBCOMPLEXITY: A new RAND study says most health-related sites require at least a high-school reading level. But nearly half of all Americans read at an eighth-grade level or below. Other results:

MISSING PIECES: The study found that 'answers to important health questions are often incomplete.'

OVERLOAD: Users of English-language search engines have only 1 chance in 5 of finding relevant information on the first page of results. In Spanish, it's 1 in 9.

Karen Springen, Nadine Joseph, Jeanne Gordon-Thomas, Julie Scelfo, Erika Check and Franco Ordonez

© 2001