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    Tuesday, January 07, 2003

    E-Medicine: More and more tertiary care centers are offering online consultations, sight unseen, as in the case of this woman who wanted a second opinion about a CT scan result:

    In Warner's case, she recently grew frustrated by the long waiting lists to get appointments with the nation's top neurosurgeons.

    ``This could be a tumor, and I didn't want to let that sit around,'' she said. ``I was worried sick.''

    When she logged onto the Cleveland Clinic's Web site in search of information, she found a link to an online second opinion service...

    She immediately gave her credit card number, filled out her medical history online and sent all her films and records to the Cleveland Clinic for review.

    Five days and $565 later, a Cleveland Clinic neurosurgeon sent her a report via e-mail confirming what her local physician suspected: The mass was a harmless, non-cancerous cyst.

    That might be fine for a second opinion radiology report, but caution should reign when applying it to most diseases. E-medicine provides only part of the equation that a doctor needs to assess a disease or a condition adequately. The physical exam plays a large part in wise medical decision making:

    `Physicians who cannot examine a patient miss out on a lot of important information that isn't in a written or electronic record,'' she said. ``They can't see the person in front of them, so you lose all those personal things, from tone to body language -- the types of things you develop as a physician.''

    For that reason, some hospitals won't provide online consultations or only offer them to international patients who can't get to the United States.

    ``By and large, I think the feeling of our physicians is if they're going to give a second opinion, they want to see the patient here,'' said Gary Stephenson, spokesman for Johns Hopkins Hospital in Baltimore.

    Sometimes it's something as simple as a gesture, or a faint rash, or the feel of the skin, or the odor of the breath that can cinch a diagnosis. There's just no substitute for sight and touch.


    posted by Sydney on 1/07/2003 01:21:00 PM 0 comments


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