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Features - Researching Medical Literature on the Internet - 2001 Update

By Gloria Miccioli, Published on September 3, 2001

Gloria Miccioli has been a law librarian for 20 years. Her specialty is research. She has worked as Government Documents/Reference Librarian at the Jacob Burns Law Library of the George Washington University Law School; as Senior Research Librarian for Williams & Connolly; and is currently International Librarian for Jones, Day, Reavis & Pogue's D.C. office, where she provides expert research services for the firm's overseas offices.


The proliferation of medical web sites is good news for the researcher with a small to non-existent medical collection. Legal researchers often have to consult medical sources, so it is fortunate that the Internet provides free access to a great deal of the medical literature, either in full text or citation/abstract format, and that it offers search capabilities good enough to fulfill most information needs. In addition, public demand for medical information on the World Wide Web is constant. Many professionally-oriented health care sites are evolving to meet consumer needs, and consumer-oriented sites often include professional literature.1

Journals, dictionaries, textbooks, indexes - all can be found on the Net in growing numbers. The sources are varied: publishers, government agencies, professional organizations, and health libraries, to name a few. A simple, if time-consuming, way to find lots of health- related links is to access a general search engine like Yahoo!. Select the category, Science. Click on Medicine and you will pull up almost 100 subcategories, including Libraries, Journals, Booksellers, and Dictionaries. Each subcategory links to various sites, of which some may be useful - or not. Under Dictionaries are links to many medical dictionaries, including one with terms in several European languages. You can also search by subject in an attempt to narrow the number of hits and get the mixed bag that usually results from a web search on a general search engine.

A more specific approach would be to directly access a medical web site.2 But which one? As usual, it depends on what you are looking for. MEDLINE, one of the jewels of medical research, is an electronic index that provides citations/abstracts to some 4200 American and foreign biomedical journals since 1966. As such, it is a mainstay of medical research, especially for current information. It has long been searchable for a fee through commercial databases. It is now available on the World Wide Web. Since it is produced by the National Library of Medicine, a government agency, it is offered at no cost on the Net and is accessible not only from the NLM web site but also from many other sites, such as those of medical libraries and medical associations. But remember: not all MEDLINE sites are the same. Some do not cover the entire MEDLINE database; some do not offer all MEDLINE search features. Read the web site's description, if there is one, to determine exactly how much MEDLINE is offered.

In fact, MEDLINE is available from the National Library of Medicine in different official versions, PubMed, Internet GratefulMed, which is being phased out and has not been updated since December 2000, and NLM Gateway. These web products are both similar and different.

Commercial Web Sites Journals and Textbooks Libraries and Nonprofit Organizations
Medical Search Engines and Visual Information National Library of Medicine Databases Physician Information

National Library of Medicine Databases

Internet GratefulMed
NLM Gateway
Internet GratefulMed was, and NLM Gateway is, the user-friendly way to search MEDLINE. Both require no knowledge of a search command language. IGM provided access to MEDLINE and 14 other databases that covered specific subjects like AIDS or that covered journals beyond MEDLINE's date range. For example, OLDMEDLINE indexes journal citations from 1958 to 1965. These databases had to be searched separately. Introduced in October 2000, NLM Gateway is a web-based interface that will search its network of NLM databases simultaneously. Right now the situation is somewhat confusing because Gateway is in the process of adding databases to its system. To see the databases currently available, go to http://gateway.nlm.nih.gov/gw/Cmd?/Overview.x. To see a list of GratefulMed databases and how to link to them now, go to http://www.nlm.nih.gov/pubs/techbull/jf01/jf01_igm_phaseout.html. For example, TOXLINE, a database on drug toxicity, iw not yet available through Gateway. You can access it at http://toxnet.nlm.nih.gov. AIDSLINE has been integrated into MEDLINE and is no longer a separate database on Gateway as it was on GratefulMed.

Despite the confusion during this transition, users will find NLM Gateway a good starting point for MEDLINE research. One of the best features from IGM is still available: the system helps you to find precise medical terminology by allowing you to search for MeSH headings. The National Library of Medicine has developed an extensive controlled vocabulary called Medical Subject Headings (MeSH); using MeSH terms in a search will lead to greater accuracy and relevancy in search results. By entering a term and then clicking on Find MeSH/Meta Terms, you can access NLM's Unified Medical Language System's Metathesaurus. Just browse through a ranked list of terms, MeSH hierarchies, and relevant co-terms, then select terms to be added to your search. You can also designate main headings. Terms will also be automatically "exploded" unless you indicate otherwise; that is, subheadings of a term will be searched along with the main heading. I can't stress enough the importance of using the MeSH function; your results will be more accurate when you use the terms assigned to the article by the indexer. And the non-medical searcher may not be able to guess the correct terms: how many would know that "mad cow disease" is represented in MEDLINE as "encephalopathy, bovine spongiform"?

There is a simple search box. Search results are divided into categories, another nice feature. They include journal articles, books/serials/AV materials (from the NLM catalog), and other collections. For each category you can get search details, i.e., how the terms fit in MeSH, and what databases were searched. Displaying results brings up citations with an option to display abstracts if they exist. You can also ask to see articles related to a particular citation, like the "More" function in Lexis/Nexis. The Limits button lets you narrow your search by document type, English language, and publication year. (GratefulMed offered many more options.) History will show you search statements and allow you to modify them. I recommend you read the FAQ on the left sidebar of the home page for basic search tips and for printing or downloading information. Gateway also links to the full text of articles available online by participating publishers, but retrieval may require a fee or a subscription. It also links to Loansome Doc, the fee-based online ordering system of the National Library of Medicine.

NLM Gateway is easy to use and allows for simultaneous searching of several medical databases. It is intended to be a first step for medical researchers. Those who need more detail and more sophisticated searching should turn to PubMed.
PubMed
PubMed is narrower in scope than NLM Gateway but it offers more powerful searching. PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine in conjunction with publishers of medical literature. PubMed does not include the NLM databases found on the Gateway home page, but it does link to the full text of articles of participating journals. At present there are links to the full text of about 1700 journals (out of some 4200 indexed by MEDLINE). Access to the full text depends on the publisher; some require a fee or subscription. For a list of journals with full- text links, click on Journal Browser on the home page, then on the list of journals with links to full text web sites. PubMed covers only MEDLINE plus links to NCBI's molecular biology databases.

Change is also in the cards for PubMed. A notice on the web site announces "a number of changes in the next few months to the display formats and search options." Click on New/Noteworthy and then on Technical Bulletin for details.

You can enter terms in a simple query box on the PubMed home page, or you can click on Preview/Index for more advanced searches. You can also search by author and journal title. To narrow your search parameters, click on Limits and use pull-down menus to restrict the search by field (such as title, title word, abstract word, MeSH heading, issue, page number and so on) and by language, age, gender, publication type, date range, and more. Read the FAQ (the link is on the left sidebar of the home page) for basic information on PubMed and take the online Tutorial.

The PubMed search engine automatically tries to match search terms, phrases, author names, and journal titles against established lists. Putting a phrase in quotes will prompt the system to search a second phrase dictionary. If a match is not found, the individual terms are ANDed together. It is also possible to search the MeSH headings in PubMed. Click on MeSH Browser on the left sidebar. Enter a term and the system will respond with the correct MeSH heading(s), which can be selected. When I entered "norplant", I got the MeSH heading "levornorgestrel", a short definition, and the term hierarchy, from which more terms could be selected and added to the search.

Search results can be displayed in brief citation format or with abstracts, if they are available. Like Gateway, PubMed allows you to retrieve related articles for most citations, because most records in MEDLINE are linked to other records by a matching algorithm. For the full text of the articles, you can link to a participating journal or order online from NLM through Loansome Doc.

PubMed has several other useful features; links are on the homepage sidebar:
  • The Journal Browser lets you look up journal names, MEDLINE abbreviations, or ISSN numbers.
  • Single Citation Matcher allows you to verify a single citation.
  • The Batch Citation Matcher allows you to verify multiple citations.
  • A Clinical Query Form is available to search for the therapy, diagnosis, etiology, and prognosis of a topic
  • Cubby is a stored search feature that allows users to store and automatically update searches (like Eclips on Lexis or WestClip on Westlaw). To register for Cubby, click on the button and follow the instructions.

Both Gateway and PubMed are attractive alternatives to fee-based sources of MEDLINE. I am impressed by the ways in which NLM has made its MeSH headings available. My experience has been that using the correct medical vocabulary is the most important factor when looking for medical information. Further, getting the actual articles has always been a time-consuming process. With the NLM web products, the user merely has to point and click to order articles, some of which may be online.

However, both systems take a bit of practice, at least for me. Maneuvering among the MeSH browser, pull-down menus, and various fields - i.e., defining and modifying the query - took time and was hard to keep track of. However, upgrades have made these systems easier to use, and no doubt this will continue. With practice, the user will find that PubMed and GratefulMed are excellent vehicles with which to search MEDLINE.

Before we leave NIH, let me mention MEDLINEplus, NLM's effort to provide consumer-oriented medical information. Launched in the fall of 1998, this system is easy to use and understand. Sources include medical dictionaries, a medical encyclopedia, provider directories, health news and access to health-related government and non- government databases, including a link to PubMed for MEDLINE searching. It would be a good place to get basic information on a disease, medical condition or treatment; you can then turn to the medical literature for more sophisticated information.

If MEDLINE is available in not one, but two, formats from NLM, why would a researcher choose to search it on a non-NLM web site? One reason is convenience, especially if he user is already on another medical site that links to MEDLINE. Often the link is to PubMed. A more compelling reason is that some sites offer MEDLINE searching with a little extra added.

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Commercial Web Sites

Medscape
One such site is Medscape, whose products are "designed to give healthcare professionals and consumers the healthcare information and digital data they need regardless of where or when they need it." This web site combines information from journals, medical texts, medical news providers, medical education programs, and materials created specifically for Medscape. Its real value is not so much access to MEDLINE as it is a collection of 25,000 free, full-text, peer-reviewed clinical medicine articles that are searchable and collected from journals or written for Medscape. Click on Search Medscape on the homepage to bring up a screen for searching MEDLINE, AIDSLINE, Medscape's full-text articles, and several databases such as Drug Information, Patient Information, Medical Images, and a Medical Dictionary. The database called "Clinical Content" contains the articles written for Medscape as well as discussion group archives, treatment updates, conference summaries, textbooks, and practice guidelines. There is so much in Medscape.com that the homepage is a little confusing. A list of links to the resources on this site, found by clicking on Site Map on the top of the screen, makes the site easier to navigate. I often turn to Medscape first when I'm given a medical research question because I can search both MEDLINE and the information produced for and by Medscape itself. As with many medical web sites, Medscape requires free registration.

Medscape's MEDLINE offers two search options: a basic screen that allows for only natural language queries (i.e., fuzzy logic), searching by author and journal, and limiting the search to English, abstracts, review articles, date and to the top 269 ranked MEDLINE journals. The advanced screen includes all this and also offers "concept mapping," i.e., the automatic selection of correct medical terms, plus searching by word variants, and a choice of fuzzy or Boolean logic. It's interesting that Medscape has designed its own search screens rather than default to Gateway's or PubMed's.

Medscape's sister site CBSHealthWatch.com was launched in 1999 and is "geared towards helping consumers manage their healthcare."
MedicineNet.com
When I do medical research, I usually try to find a plain English description of the topic before I start to search MEDLINE - and sometimes after. MedicineNet.com is a good place to go for understandable yet in-depth medical information. Produced by a network of U.S. board certified physician writers, this site has hundreds of web articles on diseases, treatments, procedures, tests, and drugs. Click on Health Resources on the sidebar to access the articles, which are arranged by category (e.g., diseases and conditions, medications, procedures and tests, and so on). Select a category and then choose from the detailed alphabetical list. To search by keyword, click on Advanced Search on the left sidebar.
InteliHealth
Another site that seeks to make health care information accessible to a wide audience is InteliHealth, a subsidiary of Aetna U.S. Healthcare. It seeks to provide "credible information and useful tools from the most trusted sources, including Harvard Medical School and the University of Pennsylvania School of Dental Medicine." Health information developed by InteliHealth is reviewed and approved by medical experts. Over 150 health care organizations, including NIH, are contributors. There is a simple query box on the home page with which to search the site. The sidebar button Health A to Z brings up a detailed alphabetical list of article topics. The sidebar also links to other types of information. For example, click on Drug Search to bring up the Drug Resource Center, with drug information, FDA actions, news, reactions, and more. Condition Center is the link to articles on diseases, conditions, and procedures. You can select from a detailed alphabetical list or a list of broader subjects. Resources links to a physician locator, the NLM site, and TopicDoc, a user-friendly medical literature service that offers a topic- driven approach to MEDLINE. TopicDoc (formerly MedCite) consists of the search results for over 15,000 topics that have been searched by medical research librarians from the Johns Hopkins health science centers. Citations or abstracts to the 50 best articles are immediately accessible for each topic. All TopicDoc searches are updated and document delivery is available. If your topic is covered, it's like having a medical librarian on hand.
Achoo
This whimsically named web site is designed as a gateway to health care sites for the medical community and other users interested in health care information. Achoo strives to include web sites that cover all aspects of health care, including business aspects. The home page allows you to select from several categories: Business and Finance of Health, Human Health and Diseases Directory, Organizations and Sources, and Reference Sources. Each category is subdivided. For example, under Reference Sources you will find Databases and Directories (which links to a simple version of MEDLINE), Journals and Periodicals, Statistical Information, and so on. The organization and layout of the categories is user-friendly. You can also choose to search by keyword via the search box on the home page. An advanced search page is available but it is not clearly marked; I found it via random clicking. Select Search on the top of the screen, then click on search Achoo from the list that pops up. The resulting search screen allows you to specify not only keywords, but also geographic location, fields, and type of site producer (e.g., e-journals, associations). A search brings up annotated links to relevant web sites. I would not turn to Achoo for strictly research purposes, but it would be useful to identify medical web sites.
BioMedNet
BioMedNet was recently acquired by Elsevier Science; it targets the worldwide biomedical research community. Free registration is required to use the site. I used to consider BioMedNet as one of the premier medical research sites on the web. Although it was a commercial site before ownership changed hands, it seemed to be dedicated to providing expert and free information. Now it seems to be more concerned with finding buyers for Elsevier journal articles. One of its most valuable features, Evaluated MEDLINE, is gone. This feature provided experts' evaluations on selected MEDLINE articles. It was a good reason to search MEDLINE on BioMedNet rather than on GratefulMed or PubMed. The site also used to link to the full texts of 12,000 articles on various topics that were part of BioMedNet's own collection and were available free. Now the user can only search this collection and retrieve abstracts for free; the purchase of the complete text not only incurs a charge but requires a subscription to ScienceDirect, the distributor for the Elsevier Science journal collection.

MEDLINE searching is adequate: there are simple and advanced search screens that allow you to Browse by Journal and Browse MeSH. You can also view, sort, and combine previous searches. Click on History on the MEDLINE search screen to see a list of searches that have been automatically saved. The Books and Labware button allows the user to browse and/or search for medical textbooks and book reviews. Online ordering is possible.

However, there is a redeeming feature: links to over 3500 medical web sites that are annotated and evaluated. Click on Web Links. You can then browse the links or search through them. If the site is even listed, you can be confident that it is of good quality. The links are rated so you can pick out the best sites, and entries are periodically updated. When I entered "dermatology" in the search box, I got a list of 52 sites. This is a great way not only to identify medical web sites but also to get descriptions and evaluations of them.

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Libraries and Nonprofit Organizations

Medical Matrix
If you need a comprehensive guide to clinical medicine resources on the Internet, run, don't walk, to Medical Matrix. This metasite annotates, evaluates and links to medical sites that are relevant to the clinical practice of medicine. Its target audience is American physicians and healthcare workers. An editorial board reviews and ranks all resources. For example, if you click on MEDLINE on the left sidebar, you will see that Medical Matrix has links to over 10 MEDLINE sites, including Gateway and PubMed and fee and free sites. It also briefly describes each site and links to a very handy comparison chart (click on View MEDLINE entries in a table format). In addition, the sites are ranked by a rating system of stars. PubMed - Advanced has the highest rating, 5 stars. Medical Matrix evaluates an enormous number of sites. For example, clicking on Rx Assist at the top of the home page brought up a rated list of 48 web sites on drugs. These sites (as are MEDLINE's) are grouped by category: searchable databases, patient education, textbooks, educational materials, and so on, so it is easy to see the focus of each site. Furthermore, MedMatrix continuously updates its content. To see an explanation of the rating system, go to http://www.medmatrix.org/info/edboard.asp#Star.

To get an idea of the breadth of coverage available on Medical Matrix, I entered "panic disorder" in the home page simple search box, I got 73 hits. (There is also an option for advanced searching.) Each listing was ranked. Users can also select to search the resources within a specialty or category found on the Home Page, which has 8 broad groupings, among them Specialties , Diseases , Clinical Practice, and Literature, including hypertextbooks, journals, and MEDLINE. Each grouping has numerous subcategories. For example, when I clicked on "Psychiatry" under "Specialties", I got a long list of ranked sites that were displayed by type of information: databases, news, abstracts, texts, major sites, conference literature, directories, practice guidelines, online forums, patient education materials, and organizational resources. Medical Matrix provides the kind of one-stop shopping and searching that we see in FindLaw, with the emphasis on quality as well as quantity.
MedWeb
As they have with all types of information, librarians have helped to make medical information more available and easier to search. MedWeb, the medical metasite of Emory University's Health Sciences Library, is impressive for its links to health-related sites located around the world (click on Institutions on the home page). It also has links to a great deal of medical information. For example, if you click on Subject Index on the left sidebar, you will be taken to a long list of medical subjects. Browse and select for relevant links. Medical libraries brings up 347 links to medical libraries around the world. MEDLINE links to various sites that offer MEDLINE searching as well as information about searching MEDLINE. Back on the homepage, the button Publications links to numerous e-publications, including journals, texts, practice guidelines, databases, directories, and encyclopedias. Some are free; some are fee-based. There is also a search box for keyword searching.
Medical/Health Sciences Libraries on the Web
Hospitals, medical libraries, and professional associations that have a presence on the Web often provide links to sites that reproduce or index medical literature. In addition, the online catalogs of medical libraries are a window to the world of medical publishing. Medical/Health Sciences Libraries on the Web links to academic, hospital, and military medical libraries and many other medical sites in the U.S. and around the world. The home page also has a link to a selected list of free full-text online electronic medical journals. In addition, this site, produced by the University of Iowa Hardin Library for the Health Sciences, compiles the Hardin Meta Directory of Internet Health Sources, a directory of what it considers to be the best health-related sites on the web. They are arranged by medical specialty.
Medical Society of Virginia
The Medical Society of Virginia is good example of a medical association that compiles links to regional medical resources. Click on Links/Resources on the sidebar to see a page of links of Virginia-based health care sites, including state and local agencies, Virginia medical schools, and nonprofit organizations. One such link is to the Eastern Virginia Medical School, whose Medical Library provides links to electronic resources such as its online catalog, PubMed, and a collection of electronic journals (from which the public can only access tables of contents and abstracts).
HealthWeb
HealthWeb has links to evaluated, non-commercial, health-related resources on the World Wide Web that are selected by librarians and information professionals at leading academic medical centers in the Midwest. Selection stresses quality and the content is directed toward both health care professionals and consumers. The first screen is a list of medical subjects. For example, clicking on Psychiatry/Psychology yields links to 12 web sites . Searching can also be done by keyword.
healthfinder
A product of the U.S. Department for Health and Human Services, healthfinder is a gateway to reliable consumer health and human services information. The medical researcher who clicks on Health Library will be rewarded with links to libraries, dictionaries, online journals, databases (including MEDLINE), foreign language resources, listservs, medical search engines and metasites.

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Journals and Textbooks

FreeMedicalJournals.com
For direct access to the current issues of several hundred free, full-text medical journals, go to FreeMedicalJournals.com. This site is somewhat mysterious; there is very little about who owns and maintains it, nor is there a total number of journals that are covered. (I estimate at least 200 titles.) Its goal is admirable: to promote the free availability of full text medical journals on the Web. The journals are sorted alphabetically and by specialty. This site also links to AMEDEO, a current awareness resource. You can enter a topic and a list of journals and you will receive weekly news updates with overviews of the new articles that have been published in the journals subset you have created. Supported by educational grants, this service is free.
Internet Medical Bookstore
Often researchers will need to consult medical texts. First, however, they must be identified and obtained. For information about medical textbooks, CD-Roms, and software that are available for sale, visit the Internet Medical Bookstore. Over 30,000 items can be ordered online. Click on Browse Our Store and you can browse by subject or search by keyword. For example, the term "anxiety disorders" brought up 36 titles.

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Medical Search Engines and Visual Information

MedNets
MedNets uses proprietary search engines to search only medical databases and is international in scope. I could not access the explanation of how it works so I can only tell you what I found by trial and error. The home page allows for searching across the site or by medical specialty by medical professionals or by consumers. It searches the medical literature of a large number of databases, including MEDLINE. Select Research Engines on the home page and you will see a list of medical specialties. If you click on one, you will be taken to a list of databases with information relating to that specialty; each database can be selected and searched individually. However, note that some of the links are not active. You can also search across the MedNets site or within each category by entering a keyword search in the simple search box on the right sidebar. It is also possible to search MEDLINE via PubMed separately using a search form on the right of the screen. There is also a search box for a general literature search. And, unique to my experience is a feature that allows you to get results from within one to sixty seconds. Search results include articles, guidelines, and other types of information.

MedNets also functions as a medical metasite. Hit any of the search engine buttons on the home page and the resulting page will have a detailed sidebar of links to health care-related web sites. These include patient and physician resources, a global list of hospitals and medical associations, medical schools, and a medical bookstore. Although MedNets covers a great deal of information, the site is not well-designed and needs more explanation.
MedBot
Another medical search engine that I would like to mention is MedBot by Stanford University. MedBot brings together several types of resources: general search engines, medical indices, news sites, medical education, and medical imaging and multimedia sites. Some of these resources can be combined for a single Super Search; the user selects up to 4 databases to be searched at one time. Or, you can click on each category and search the listed sites one at a time.

The button marked Medical Images and Multimedia underscores the fact that the research of medical sources is often a hunt for visual information. The fact that the Internet is not restricted to textual medical information makes it an extremely valuable research tool. Clicking on that button on the left sidebar brings up query boxes for:
  • WebPath, an electronic collection of 1900 images of pathology specimens along with text, tutorials, laboratory exercises, and examination items.
  • The Digital Anatomist, a collection of computer-generated images based on cryosection studies
  • Virtual Hospital

When I tried to find some images, I was more successful in searching the above web sites directly from their home pages than I was in using MedBot. Entering "stomach" in the MedBot query box for WebPath brought up two hits. Entering stomach in the WebPath search box retrieved 38 items. I could also browse "General Pathology" and "Organ Systems Pathology."

Medscape also has compiled a file of medical images. Its search box allows the researcher to click on Medical Images and search for visual information. I entered "keratosis", which is a skin lesion, and got a thumbnail image. Clicking on the image brought up a screen-sized version with a caption and the source of the image.

Researchers can search a Findlaw database of over 10,000 medical images. The illustrations were developed for legal matters, such as medical malpractice exhibits. Enter a term in the query box or select from an alphabetical list. Selecting "knee caps" brings up 1 anatomical model, 27 stock illlustrations, 4 medifocus guides, and 18 medical exhibits (Findlaw explains each category). Click on an image to enlarge it. Downloading the image, however, incurs a fee.

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Physician Information

Researchers often need information on medical providers as well as on medical conditions. Licensing data and educational background are usually available, but the availability of disciplinary information varies from state to state. The watchdog group Public Citizen conducted a survey of Doctor Disciplinary Information on State Medical Board Web Sites in order to determine which states publish disciplinary information on the Internet. It surveyed 51 boards that regulate medical doctors and found that 41 boards name disciplined doctors on their web sites. The earliest information dated from 1996 so this is a relatively new, but very welcome, development. A table at http://www.citizen.org/hrg/PUBLICATIONS/1506uptodate.htm lists the state boards and tells what information is given. It also provides links, if available, to the boards' web sites, which usually also give licensing data and educational background.

If you are not satisfied with what you can find for free with regard to disciplinary actions against doctors, you can use the Federal Physician Data Center, which was launched in early 2001 by the Federation of State Medical Boards, whose membership is comprised of the 69 medical boards of the states, D.C., Puerto Rico, Guam, and the Virgin Islands. The Data Center lists 117,000 state board charges against 35,000 doctors dating back to the 1960s, although some information goes back to the 1940s. The site covers only U.S. medical licensed physicians, osteopathic physicians and physician assistants. To be included in the database, a disciplinary action must be a matter of public record or be legally releasable; there is no information on malpractice claims or settlements. The database, which is updated monthly and quarterly, costs $9.95 per search, whether an action is found or not. Users will learn whether action was taken, what type of action (e.g., license revocation), and the date and reason for the action.

Virginia's Board of Medicine Practitioner Information web site provides an example of the controversy surrounding public access to physician information. In 1998, the state legislature approved the re-design of the web site as a comprehensive source of information on physicians, osteopaths, and podiatrists. The site had its debut in July of 2001. The breadth of information that is supposed to be provided is indeed impressive: office and hospital affiliations, education, board certification, practice areas, honors academic appointments, publications, proceedings and actions and paid malpractice claims. Most of this information is available online. However, emergency legislation was passed in July to bar the posting of certain disciplinary information on the web site, although the information is available to those who write, call, or e-mail the Board. Under the new law, only final disciplinary orders will be on the web site. Pending cases and those that do not result in disciplinary action will not be posted, at least not as of this writing. Nevertheless, it's clear that people want physician information: a Washington Post article notes that over 16,000 hits were recorded within the first 36 hours that the web site was online.3

The Internet has become an important source of information in medicine and the health sciences, as it has in so many other areas. Medical information professionals are at the forefront of the effort to organize this vast, ever-increasing store of knowledge. The sites mentioned above reflect this effort and are meant to be a sampling of the marvelous tools that are now available to the medical researcher. Take some time to explore medicine on the Web; no doubt you'll discover many more.

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Footnotes

1 For discussion and review of medical information on the Internet, see articles in USA Today, July 14, 1999. Also in USA Today of July 19, 2000, see "Some Useful Web Resources."  <back to text>
2 I am going to discuss selected web sites. For an excellent, comprehensive introduction to medical research on the World Wide Web, see "How to Search for Medical Information," by Frank Kellerman, Mary Zammarelli, and Robert Balliot at http://204.17.98.73/midlib/www.htm.  <back to text>
3 See "New Tech, Old Politics: Virginia Doctors Block Web Access to Data Available by Phone, Mail," by Sandra G. Boodman, in Washington Post, July 31, 2001, p. F1, for an analysis of the politics behind the ban."  <back to text>