title: Web relationships between physicians and individuals seeking information on hepatopancreatobiliary diseases.
abstract: 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.
authors.affiliation: Liver and Multi Organ Transplant Unit, University of Bologna, Policlinico Sant'Orsola Malpighi, Via Massarenti 9, 40138 Bologna, Italy. glgrazi@unibo.it
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
mesh_terms: 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