The internet has a wealth of knowledge

For many of us it has become the fountain of youth, while for others it is another suspicious source of confusion and manipulation regarding what to eat, drink or who to approach for health advice. Famous authorities in various health-related matters often delegate their web or blog articles to others for editing, typing or even writing. Some of them delegate book chapter writing and even the writing of whole books for which they get famous a few years later. Their time is valuable, but so is yours. It turns out that a well-trained mind (read “an authority in the matter”) with recognized training and experience in the field will only produce something of value if the one dedicates the due time to the actual topic. Delegated to the wrong people, even the brightest idea will fade and never achieve full momentum in helping others. In healthcare, students and residents are trained by being assigned smaller portions of a bigger project – and that is a great learning and a purposeful use of their time as well. If lucky enough and after putting in sufficient effort, a number of them may become co-authors on the respective work and that is a win-win. Others may only help by gathering scattered evidence from the field. Although not worthy of authorship, such experiential learning provides the student/resident with new skills in identifying and selecting quality literature and saves the project leader the time to search and gather this evidence. Although flawed to some extent, this approach is NOT the one that I am concerned about! What terrifies me is delegating writing to someone you never met, never trained, and never graduated from a healthcare education program. Clinicians do not have the time to write popularized science – by that I mean the type of authentic and trustworthy information that is translated into a lay language that any reader of any background and education level could understand and apply. Clinicians are also too expensive to hire by a website to write regular articles. Yes, some of them proudly accept the invite to write once, twice, maybe three times for a famous website – but patients require much more, the demand for healthcare education is impressive! This increasing demand for lay-translated healthcare information and the websites’ need for viewership led to an increased hiring rate of non-healthcare trained writers.

In healthcare, the moment of such a realization is painful and frustrating on both the side of the clinician and the one of the patient. This is not only incomplete information but also dated and/or misleading information. Ironically, as opposed to a one time 15min counseling session during the annual check-up or at the pharmacy counter, the information published on these websites is more likely to be followed. Written in a more accessible language, being easier to read and understand and being re-accessible on demand makes the implementation of that information more efficiently than the counseling session with a physician, nurse or pharmacist. Well, is it better than nothing you think? Hell, no! when it comes to healthcare, efficiently-delivered dated or misleading information is as bad or worse than receiving no information at all. Why is that? Because it has a higher chance to substitute common sense with the dated or misleading information!

So, why then do clinicians not take the time to do it themselves? Well, the answer to this question is complicated. As a clinician, if you write for the patient then you do not write for your peers. This means that you would focus less on advancing the science in your field. Then you do not publish peer-reviewed literature – your only source of recognition and validation in your field. Without this, “somebody” soon becomes “nobody”. This means losing the ability to secure credibility and to access the best logistics of one’s own field (e.g. not be hired by famous hospitals, clinics, universities). These are essential to provide the best possible clinical care for the patients; so it is not at all something one could bargain easily! See the vicious cycle here? Like an ironic conspiracy of the internet, most of the catchy health-related articles written in clean-grammar English on the web are rather the product of health-literate journalists and not the product of clinically educated (and graduated!) doctors – and by “doctor” I mean one who achieved a doctor degree in a science that can impact human health, be it medicine, nursing, pharmacy, immunology or microbiology. I mean a PERTINENT voice for the written matter. Instead, the reading you enjoy is often a classical web-review conducted by an English-major grad, not by the clinician, academician or scientist-educator with hard-acquired experience. I have nothing against and, in fact, highly respect the English-major grad that writes novels, teaches English or does anything related to the field of training. But when it comes to the healthcare information written by an English-major, the recommendation you trust is rather a concoction of old established evidence with minimal liability potential. It has NOTHING to do with educating you about your health and I’ll tell you why.

If you go to the doctor to check on a broken leg or have your medicine administered by a nurse or have another medicine checked or dispensed by the pharmacist, I have the vague assumption that you would like to be provided with the top-notch, most recent, up-to-date possible knowledge that you can have access to. Perhaps – again, an assumption – you would like the entire healthcare-related process to be provided by individuals that are graduated from recognized schools, passed all their exams and got licensed by professional boards approved by the Department of Education. You might also expect them to have practiced long enough under the supervision of other more experienced professionals to develop the necessary knowledge before making decisions on something that impacts…YOUR LIFE. Such a process is called an internship and there is another one called residency. Overall this supervised training may take anywhere from 4 to 7 years, after completing the last official course in a degree program, and get the individuals pursuing this path into debt that amounts to considerable 6-digit values in many cases! So, I can only assume that your expectations for the quality of the healthcare you want to be provided with are equally as high as the bar for training and licensure. Do I get this right?

While clinicians are busy applying the latest evidence, the writers get curious collecting information written by others and then creatively re-writing it to avoid being accused of plagiarism. While a fine work of art from an English and journalism perspective, the scientific and clinical concept behind it is now not only twisted but may be flat-out wrong. Play this game twice or three times (because there is always a second and third writer that each reads the materials of the first writer), add an interview or two that was originally targeted to a specific narrow-niche audience and one that had some commercial or political bias and there you have it: the cocktail of information is now a poisonous concoction. Ready for you to apply in your day-by-day life, test on your kids, parents, grandparents, neighbors, friends and any other one you care about. Then, for God’s sake, why would you take on-line recommendations that you read from a “writer” that got paid $1 for every 100 words written about “hot” health topics and proceed to rigorously apply them at home for the sake of improving your health?! Would you go to the same writer for diagnosis, treatment, or evaluation of side effects? If not, why not?

The difference between what the $1/100 words-writer writes and what I write myself on this blog is simple: I am schooled and licensed to provide the clinical information that I provide here for you. I am trained to identify a good source of scientific and clinical information from a not-so-good one. Fact verification in science and clinical care is my second nature. I went to school to the extent of my family joked about the fact that I was still a student after 20 years. I was licensed and still went to school to learn more. I was teaching hundreds of students and still studying, researching, …failing, and learning from my mistakes. I cared for patients and helped people throughout the way and I felt rewarded for my work. However, the moment I realized that if I die tomorrow all I learned will be lost, I started writing it down and I decided to share it with the world in a way that everyone can understand it. And here it is!

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Dr. Alice

I teach people how drugs work, when they are needed, and why. My expertise as a pharmacist and researcher allows me to determine whether taking or not taking a drug will pose any risk given all current circumstances that apply at this moment. Many times we don't know unless we try, but other many times walking the extra mile pays off giving in return more wonderful moments and more to give to others.

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