It's the Information Age. With the click of a mouse you can communicate with practically anyone, anywhere, and an unfathomable number of sites crowd the World Wide Web. All of this access to information is a good thing, right? Is it possible there is too much information? Some physicians may think so.

A growing number of states, medical organizations, physician practice groups, and for-profit organizations are peppering the Internet with physician profiles. They are available to anyone with access to the Net, and offer information about physicians' education, medical specialties, board certifications, and office locations.

That's the good part. On the flip side, many of these profiles also offer information on malpractice judgments or disciplinary actions, putting some physicians at a distinct disadvantage for attracting patients and maintaining their professional integrity.

There is general agreement that these profiles can be helpful tools for consumers making important decisions about their medical care. Moreover, they can generate free advertising and publicity for doctors. Online profiles are probably most beneficial to physicians who provide high-profile services like plastic surgery, says Stan Colquitt, founder of Medical Market Analysts, a Charlotte, N.C.-based physician marketing and business consulting firm. Tertiary-care doctors get most of their business from word-of-mouth, Colquitt notes, so patient access to information on the Internet probably only serves to confirm or refute what they hear about a doctor.

But some physicians may find they are on the receiving end of just the kind of advertising they don't need; and some in the medical field question whether the content of these sites, especially those operated by private companies or established by physician practice groups, is accurate — or of any value at all if the information isn't put in proper perspective.

'Nothing to hide'

"There is not a direct connection between bad doctors and bad cases," says Michael A. Grodin, MD, of the Boston University School of Public Health. In other words, a single lawsuit brought against a physician is generally not a reflection of poor professional performance. Grodin, who is also an attorney, believes that profile information should be available to consumers, but that online profile creators must be "appropriate, responsible, and sensitive in what appears."

"We thought people would be able to make appropriate choices with the information we put out," says Bruce W. McIntyre, deputy chief legal counsel of the Rhode Island Board of Medical Licensure and Discipline. In 1997, Rhode Island followed Massachusetts' decision a year earlier to place physician information on the Internet; they are among the growing number of states that post judgments or actions against physicians.

Physicians, for the most part, appreciate that these sites provide them with free marketing, says Dale Austin, interim CEO of the Federation of State Medical Boards of the United States (FSMB). "Most doctors have nothing to hide and a great deal to share and it gives them an opportunity to tell their story," Austin says.

Several years ago, however, the New England Journal of Medicine reported that about 23 percent of doctors had either a malpractice award or disciplinary action on their records. Such physicians worry that patients discovering even one such incident in a profile will consider it the rule, not the exception. Meanwhile, McIntyre and others say it's rare for more than one disciplinary action to ever be filed against a doctor.

Patients going online to research their doctors must receive enough information to make informed decisions, says Louis Goolsby, MD, senior vice president for medical affairs for the Medical Center of Central Georgia, a 518-bed regional facility in Macon, Ga. But he and others question whether consumers can understand the data contained on physician profiles. Do consumers know that hospitals, managed-care organizations, and insurance carriers often dictate settlements regardless of guilt, he wonders?

"If good assessments are put where consumers can see and understand them, then that's beneficial to everyone, but if they are just data points, with no explanation, no perspective, then that can be bad," Goolsby says.

"An Internet site looks like an Internet site looks like an Internet site," adds Austin. "It's hard to distinguish one from another, good content from bad, self-reported or self-promoting from verified information." His organization suggests guidelines for putting physician profiles online, including verification of all information by the state and the doctor.

The American Medical Association posts some information at its AMA Physicians Select Web site, as do the American Board of Medical Specialties and the Administrators in Medicine. But none of these sites offer reports on medical malpractice awards or disciplinary actions taken.

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