Web Sites Offering Second Opinions Raise Concerns
Offering the "latest and clearest" indication that some physicians are practicing medicine over the Internet on patients they have never seen, a number of new Web sites are providing patients with online second opinions, the Los Angeles Times reports. Although some major teaching hospitals, including the Johns Hopkins School of Medicine, have offered "remote access" to specialists for some time, the Times reports that there are "at least" a half-dozen Web sites that are not affiliated with major institutions that offer second opinions. For example, eSpine.com charges patients $75 for a review of spinal X-rays and CT scans and a phone consultation with an orthopedic surgeon specializing in spine operations. Another site, FindCancerExperts.com, links patients who have been diagnosed with cancer to pathologists who review biopsy slides to ensure they have been interpreted properly. A third site, MDExpert.com, charges between $450 and $800 for a cancer specialist to review medical records and discuss treatment options and medications. While these services are "generally not" covered by insurance, the Times reports that they provide a "lifeline" for some patients.
Still, most physicians "draw a very clear line" between what can be handled well online and what needs to be handled in person. While many tests, such as biopsies and X-rays, can be interpreted without an exam, doctors caution against following online medical advice without personally talking to a physician. Dr. Richard Corlin, a gastroenterologist in Santa Monica and president-elect of the American Medical Association, said, "Any evaluation of a patient still begins with history and physical, and review of lab work." He added that "the ability to get history is somewhat limited online, and the ability to get an exam is obviously not there at all." In addition, Corlin said that "quality control" will become an issue as second-opinion Web sites proliferate. Dr. Robert Pashman, who consults with eSpine.com, said, "The question becomes are you certain you're speaking to who you think you're speaking to, and the qualifications are what they say? You may not be talking to a 15-year-old boy in Montana, but the principle is the same -- how do you know?" (Carey, Los Angeles Times, 5/28).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.