Medpedia Debate Reignites War Over Who Is Most Qualified To Develop & Vet Medical Information
Last week, a new medical wiki, Medpedia, received significant attention when it announced that several major medical institutions, including Harvard Medical School, were partnering with the startup. Mark Senak who writes at Eye on FDA, suggested that “when given a choice of learning about the drug from (1) the manufacturer or (2) an objective third party source representing the finest medical schools in the country, patients and physicians are likely to gravitate to the objective resource.” He also believes that “the influence of Medpedia on prescribers . . . and patients stands to be quite large.”
While Medpedia allows anyone to contribute information, it only gives physicians or PhDs the ability to serve as editors. These highly credentialed individuals will have the final say on what content ultimately makes it into the online publication.
This restriction has incensed some advocates of full and equal patient participation in medical information sharing, development and dissemination. In an impassioned post published recently on e-patients.net, Dave deBronkart took Medpedia to task for restricting access to the site. He wrote: “[W]hat patients need from an online resource is reliable information on topics where they’re not experts . . . And my experience is that it’s an error to presume that doctors inherently have the best answer[s].”
To his credit Medpedia founder James Currier responded to deBronkart’s essay, saying: “I want to make it clear [patients] ARE being invited in. There are already several key features that anyone — whether medical professional, expert patient, or layperson – can use to engage. Anyone can create a profile. Anyone can create or join a Community of Interest to connect and debate (they are admittedly rudimentary today but will be improving in the coming months), and anyone can use the Suggest Changes feature on every Article page. Use these features vigorously.”
The ongoing debate over Medpedia and its editorial policies illustrates – yet again – that some Internet empowered patients and caregivers are chaffing and outright rebelling at the traditional hierarchy of the medical establishment. Although they respect physicians, they do not automatically view them as the most authoritative source of health information.
In fact, according to a study my firm Envision Solutions published last year, thirty-eight percent of U.S. adults say they have doubted a medical professional’s opinion or diagnosis because it conflicted with information they found online.
Because a good number of physicians believe that a lot of online medical information is of low quality, they worry that patients are second-guessing their advice (or orders) based on shoddy information. Is Medpedia an attempt by the medical profession to ensure that (via the magic of search engines) content a broad range of content physicians have vetted finds its way into the hands of patients and others? Would it be a stretch to posit that some people behind Medpedia wish to dampen the disruptive impact of the Internet by ensuring that content people are seeing is consistent with broad medical practice or opinion? After all if the information patients are reading is consistent with standard medical advice there is less room for disagreement.
The Medpedia debate is another skirmish in the war medical professionals and active laypersons are fighting over the future of medicine. E-patients like deBronkart trust physicians, but know they are prone to errors of fact and omission. Medpedia respects the contributions of patients, but maintains that “physicians and Ph.D.s in the biomedical fields have gone through extensive training and screening before receiving their degrees, and those degrees can serve as an efficient proxy for the Medpedia community to judge an Editor’s ability to contribute accurate and up to date information to the encyclopedia.”
In the end it comes down to what credentials one believes makes people best qualified to develop medical content: a degree + clinical experience or extensive research + personal experience. It’s clear where the creators of Medpedia come down on this question. Where do you stand?
