Technology

Here Come the Cyberchondriacs


As patients shoulder a bigger burden of their health-care costs, they're increasingly looking for medical information online—before seeing a doctor

During a ski trip to Lake Tahoe last Thanksgiving, Minna King noticed that her 1-year-old son was exhibiting some atypical behaviors: He was rubbing his cheek and crying more than usual. King wasn't sure whether it was a reaction to climate and altitude change—or something worse. So, she went online to WebMD and discovered that his symptoms were consistent with an ear infection. "It was because of WebMD that I could make the decision to spend $100 to take him to the emergency room," says King, who consults for business-networking site LinkedIn.

King's search reflects a surge in use of online health sites that's giving many consumers greater control over their health-care decisions and turning the traditional doctor-patient relationship on its ear. More than 160 million Americans have searched for health information online, a 37% increase from 2005, according to Harris Interactive (HPOL) polling data released July 31. The rise in ranks of what the Harris Poll calls cyberchondriacs is having "a big impact on the knowledge of patients, the questions they ask their doctors, and is therefore changing the doctor-patient relationship and the practice of medicine."

Complicated Plans

Some would-be patients are using the Internet to fill knowledge gaps left even after hospital stays and visits to the physician. And in an era when patients are shouldering an ever greater portion of skyrocketing health-care costs, many consumers like King are using health sites to decide whether to visit to the doctor in the first place. "Today we're more responsible financially and behaviorally for the care we receive," says Wayne Gattinella, CEO of WebMD Health (WBMD), owner of WebMD.com. "It's driving a greater need for health information to help people make more informed health decisions."

WebMD should know. In June, WebMD had about 17 million unique visitors, a 28% increase from a year earlier, according to comScore Media Metrix, a division of comScore (SCOR). The company says its average of monthly visitors is considerably higher, at more than 40 million. But even using June comScore data, WebMD lured about 9 million visitors more than the No. 2 site, Everyday Health, which is affiliated with the sites of several diet and wellness industry celebs, including Arthur Agatston, author of The South Beach Diet. Microsoft's (MSFT) MSN Health came in at No. 4, with 7.95 million visitors. Yahoo's (YHOO) health site and Time Warner's (TWX) AOL Body ranked fifth and sixth, respectively.

A big motivator for learning as much as possible about a medical condition online is the proliferation of health plans that include high deductibles and cash reserves that can be set aside tax-free if used on health care, say WebMD and other experts. "The new plan designs include high-deductible health plans that increase consumer responsibility for health-care costs and health-care decision making," WebMD says in regulatory filings explaining the rise in its traffic.

Price Comparisons

High-deductible health plans usually require patients to shell out more than $1,050 for an individual and take more financial responsibility, according to management consulting firm Booz Allen Hamilton. And according to America's Health Insurance Plans, an association of health insurers, the number of people enrolled in such high-deductible health plans offered in conjunction with health savings accounts rose 43%, to 4.5 million, as of April.

Cyberchondriacs don't just want information on medical conditions; they also want to know how much they should pay for treatment—and whether a doctor has a reliable track record. According to the April report by Booz Allen Hamilton, about two-thirds of patients who bear higher health-care costs would like to see data on expected out-of-pocket costs for a medical procedure and information about a provider's medical errors and safety rate. Currently, only 19% of physicians make information about safety or medical error rates for specific treatments available and just 16% of those surveyed said they plan to do so in the next two or three years.

After one New York resident was told by her dentist she needed dental and periodontal work done, she turned to WebMD and the American Dental Assn. Web sites. It's not that she doesn't trust her dentist, but she wanted to be sure that all the work proposed was truly necessary. The data she uncovered reassured her the work was necessary, though she says she would have liked better information about price. "I went online and I found some place that told me what Medicare or Medicaid would pay," but little more, says the woman, who asked not to be identified because she wanted to keep her medical information private. Over the last 12 months, she's spent about $5,000 on dental procedures because her insurance plan covered only half the cost.

Great Tool

For their part, doctors say they don't mind when patients turn to Web sites for information and arrive at appointments armed with data. Nearly two-thirds of doctors surveyed say this trend is positive, according to a recent study by Manhattan Research. In fact, about 52% of U.S. doctors recommend health-related Web sites to their patients, says Mark Bard, president of Manhattan Research. "The amount of information you have access to today is exponentially greater than you had 10 years ago," he says.

"Overall, I think it's a good thing. People need to have access to good information, and they need to be in control of their medical problems," says Dr. Rick Kellerman, president of the American Academy of Family Physicians. "It's like any medication, though; there are always side effects and adverse reactions," he says, referring to the difficulty of determining the veracity of all the medical information available online. Kellerman says he recommends familydoctor.org because information is peer-reviewed on the site. He also likes WebMD and Revolution Health. Kellerman says he thinks more doctors will actively recommend sites they like in years to come. "We'll be able to direct patients more to information that we know is reputable," he says.

For now, though, Minna King says that WebMD meets all her online health needs and that she doesn't need to visit any other sites. While she has quality health insurance through her husband's employer, using WebMD is a convenient tool for getting information. "It's an excellent plan but for me to see a specialist would take so many appointments and so much time," she says. "WebMD is a great tool to make sure I don't spend my time or my money when I don't have to."

Check out BusinessWeek's slide show of the 10 most popular health-related Web sites in June.


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