Web relationships between physicians and individuals seeking information on hepatopancreatobiliary diseases.
OBJECTIVE
The Internet has led to widespread Web consulting, the proportions of which are not yet known; there is not yet agreement on its management.


METHODS
We verified the typology and needs of people and patients of a single-language population inquiring about a homogeneous group of diseases treated in tertiary reference centers and their reason for writing. Data were extracted and coded from e-mail messages received over 27 months by a noninstitutional Web site devoted to surgically treatable hepatopancreatobiliary diseases. Consultation activity was verified by the number of answers and subsequent messages.


METHODS
One thousand forty-seven users sent 1788 messages to one of the Web site addresses; 1179 (94.6%) of them inquired about clinical problems. Data were collected on the demographics of senders and patients, the nature of the clinical problem, and the reasons for the messages.


RESULTS
A mean of 2.1 messages per day were received. Queries were sent by patients in 260 instances (22.1%) and by others in 750 (63.6%). Two hundred thirty-seven (20.1%) e-mails had medical enclosures. The presence of a malignant disease was reported in 705 messages (59.8%). Description of previously undertaken therapy was present in 613 cases (52.0%). An answer was given to 1177 first messages (94.4%) and a follow-up message was received from 401 users (34.1%). Second messages were characterized by a shorter time to receive an answer (mean, 2.5 +/- 3.6 days vs 3.5 +/- 5.3 days). Each user sent a mean number of 1.4 +/- 0.7 messages (range, 1-8).


CONCLUSIONS
Web consulting is a powerful tool for patients and health professionals that emerged owing to physician communication problems. Nevertheless, the Internet is still pushing physicians toward a reconsideration of the principles of medical ethics and a reevaluation of rules and regulations to deal with these new communication methods.
Grazi
Gian Luca
GL
Liver and Multi Organ Transplant Unit, University of Bologna, Policlinico Sant'Orsola Malpighi, Via Massarenti 9, 40138 Bologna, Italy. glgrazi@unibo.it
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases; D005260:Female; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D008107:Liver Diseases; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases; D010817:Physician-Patient Relations