Where to Get Your Own Answers to Medical Questions
By Deborah Pate, DC, DACBRWhen contemplating a major purchase, many people take more time to learn about a product than they would learning about their own health. I won't address this odd phenomenon. I'll leave that to the psychologists, but I would like to help inform those interested in their own health, and assist them in making educated choices about medical problems.
While plenty of health information is available, it's not always easy for the average person to find the right information or to understand the Medical jargon. But with some patience and persistence, people can find what they're looking for, whether it be an experimental treatment for arthritis or locating a hepatitis C support group.
Next to extensive consultations with a doctor, which isn't very probably in the age of managed care, the local library is the best place to start, unless you are skilled in the use of the Internet. Most public libraries have a collection of medical reference books and journals, and some offer computerized databases to search for health information. The reference librarian can familiarize you with the medical resources available and help you get started. If you live in a university town, most universities have extensive libraries, and some have a medical libraries. Most of the information is available to the public. If you cannot check out a book, almost all libraries have copy machines, or you can sit and read the information there and take notes. (Many of us seem to have forgotten the skill of just taking notes.)
If you are unfamiliar with a topic, a medical encyclopedia is the best place to start. It will give you an overview of just about any medical condition. When you can't find enough information in general books, it is time to look at the medical texts that most physicians use for reference.
First, take out a medical dictionary so you can make sense of some of the terminology. The Merck Manual is a compendium of almost every known disorder and describes causes, symptoms, laboratory tests, diagnosis, treatment and prognosis. Harrison's Principles of Internal Medicine will go into even more detail than the Merck Manual. The Physician's Desk Reference is a good resource to learn about any medication. For nutritional information, take a look at the Corinne T. Netzer Encyclopedia of Food Values and Nutrition Bible. For other types of therapies, The Alternative Health and Medicine Encyclopedia can be useful.
Most libraries can perform online searches which have indexed hundreds of popular magazines, newspapers and journals, including the Journal of the American Medical Association, the New England Journal of Medicine and other medical publications. You can search using keywords or subject headings. Often, the full text of the article is available.
Some libraries also have MEDLINE, the National Library of Medicine's computerized database of articles that have appeared in 3,800 biomedical journals from 1966 to the present. More than 30,000 new citations are added each month. By searching MEDLINE, you can get citations and abstracts of articles on a given subject, but not the text. You can request the text from your library or request it from the journal.
If you do not want to or cannot use a computer, there are two indexes that, though updated less frequently, are available in most libraries: Consumer Health and Nutrition Index and Reader's Guide to Periodical Literature. These list articles on health and medicine that appeared in popular magazines.
For information about your physicians or hospitals, there are several resources available. The American Medial Association's Directory of Physicians in the United States lists the address, medical school, year of license, primary and secondary specialties and board certification for all physician members. The Official ABMS Directory of Board Certified Medical Specialists provides similar information for physicians who are certified by the American Board of Medical Specialties. You can also call the board to find out if your physician is board-certified.
Even more importantly, to find out whether your doctor has ever been disciplined by a state medical board, consult Questionable Doctors, published by the Public Citizen Health Research Group. I am not certain how often this information is updated. I would also contact your state medical board to find out if a physician have ever had any action on their license. For information on chiropractors contact the state board of chiropractic in your state. For a list of state medical boards and licensing agencies, consult How to Find the Best Doctors, Hospitals, and HMOs.
The Hospital Blue Book is organized by state and lists each hospital's owner, medical school affiliations (if any), number of beds and special services. The Best Hospitals in America lists top hospitals in North America. Many health organizations also have 800 numbers, so getting an answer won't cost you big bucks on the telephone bill (see "for a list of toll-free numbers" later in this article).
The National Institutes of Health (NIH) is the U.S. government's focal point for health research and one the world's foremost biomedical research centers. It encompasses 24 institutes that conduct research on almost every disease known presently. Many of these institutes operate information clearing houses that can be reached by telephone; most require a written request.
The most comprehensive clearinghouse is the Cancer Information Service, operated by the National Cancer Institute. It provides information about the latest therapies, clinical trials, treatment centers, community services for cancer patients and their families, FDA-certified mammography facilities and more. When you call, be prepared to hold for 10-15 minutes. Once you get someone, however, you will be connected to a knowledgeable person who will take the time to give you the information you need.
Several other institutes operate similar services for other diseases and provide articles, pamphlets, brochures and information about clinical trials sponsored by the NIH. These include the National Institute on Aging's Alzheimer's Disease Education and Referral Center; the National Institute on Deafness and Other Communication Disorders; the National Eye Institute; the National Digestive Diseases Information Clearinghouse; the National Heart, Lung, and Blood Institute; the National Institute of Diabetes and Digestive and Kidney Diseases; and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
The one thing that these clearing houses are not allowed to do is give referrals to physicians and specialists. To find specialists in your area, consult the Associations' Yellow Book which includes addresses and phone numbers for virtually all medical organizations, or volume one of the Medical and Health Information Directory. Both are available in most libraries.
For rare diseases, call the National Organization for Rare Disorders (NORD). NORD has information about ailments that affect fewer than 200,000 people in the United States. They can send publications and refer you to other helpful organizations, including support groups for people who share the same rare condition, or even to individual patients.
Many voluntary health organizations, including the American Cancer Society, the Alzheimer's Association, the American Heart Association, the Arthritis Foundation and the American Diabetes Association can be reached at no charge. For a list of toll-free numbers for health information write to the National Health Information Center, P.O. Box 1133, Washington, DC 20013-1133. The AT&T Toll-Free National 800 Directory, which can be found in many libraries, is also another good resource. For questions about nutrition, call the International Food Information Council.
If you are computer literate, you can turn your home into a library at any hour of the day or night. You can consult bulletin board services, post messages to members of online support groups, search MEDLINE or explore the Internet, which links more than 20,000 computer based networks. Scores of books have been written on how to use the Internet, and many commercial services offer easy access.
There are two main types of health-related resources: reference materials and discussion groups. The latter, such as the Cancer Forum on Compuserve, allow you to contact people with similar medical problems and sometimes to find experts. Universities, hospitals, government agencies and many health organizations all maintain websites. For a comprehensive list of medical resources available on the Internet, try the Medical Matrix, which is complied by members of the American Medical Informatics Association (see "Best of the Web" list).
When surfing the Internet, it is important to remember that you shouldn't believe everything you see on your monitor. Unlike articles published in peer-reviewed medical journals, there's no guarantee that information on the Internet has been checked for accuracy or even updated regularly. Some sites are set up by pharmaceutical companies or manufacturers of nutritional supplements and exist primarily to sell products. Be cautious and double-check the information that you find.
If you are short on time and money is no object, you can pay a professional researcher to answer your health questions. MedCetera, Inc. in Houston, Texas offers several packages ranging from a basic MEDLINE printout to more extensive searches that can supply full-text articles. Health Resource, Inc. in Conway, Arkansas provides comprehensive research reports on specific medical conditions.
The information is there. You just need to take the time to access it.
List of Useful Books (recommended by the Harvard Health Letter, July 1996)
"Best of the Web," (recommended by the Harvard Health Letter, July 1996)
Recommended Chiropractic Web Sites:
There are dozens of quality chiropractic sites available for viewing on the Internet. A good way to access them would be by logging into Dynamic Chiropractic's "Links" section on their website (http://www.chiroweb.com/forum/important.html). This page contains more than 130 links to chiropractic colleges, associations and publications and other health-related organizations, government agencies and online information libraries.
Note: Much of the information in this article was obtained from the Harvard Health Letter.
Deborah Pate, DC, DACBR
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