Bread upon the waters.. Award-winning author Tom Ferguson is president of Self-Care Productions, a health care consulting firm in Austin, Texas. He founded the influential journal Medical Self-Care and has served for many years as medical editor of The Whole Earth Catalog. He wrote the chapter "Working With Your Doctor" for the book that accompanied Bill Moyers' PBS series Mind/Body Medicine. Ferguson is a Yale-trained physician who has saved hundreds of lives by refraining from the clinical practice of medicine. As a senior associate at Harvard Medical School's Center for Clinical Computing, he is organizing one of a series of conferences on computer networks that support the informed, responsible health consumer. The author of a dozen books for the empowered medical consumer, he speaks widely on the role of the "New Medium" in medical practice. We met recently for lunch to talk about his new book Health Online. Toward the end of our conversation, at the request of my chum Maureen, I asked him why we didn't get goosebumps on our faces. He said he didn't know. My kinda doc... (This piece was written under the auspices of the Pacific Sun newspaper of Marin County, California.) Home Back

The Doctor is Always IN. Health OnLine sounded like the kind of thing where you describe the symptoms of your ailment in a box at an obscure website, and five minutes later you get an eMail back telling you to go to your doctor. Five minutes after that another mail arrives. Your credit card has been charged $10. A sort of "Dean Edell in Cyberspace". Me? Skeptical? Health Online is, in fact, a book by Tom Ferguson MD. Ferguson - or Dr Tom as he prefers to be called - is President of Self-Care Productions, a consulting firm in Austin, Texas. He has strong ties to Marin both as a former long-time resident and also as Medical Director of the Millennium Whole Earth Catalog. The volume can be described as a directory of health-care resources on the Internet. It's in three parts. Part I covers the basics of being online - eMail, netiquette and so forth. Part II reviews the self-help "virtual neighborhoods" of the three major online services, America OnLine (AOL), Compuserve and Prodigy. Part III reviews newsgroups, mailing lists and information resources on the Internet. It is a starting point for those interested in self-help health resources online. However, such is the lead-time for print, many of the resources described are inevitably out of date or have been superseded. The significance of the book lies beyond its contents. It is in its publication and provenance. By legitimizing the Web as a source of advice and information, Tom Ferguson is laying the groundwork for a movement which will ultimately upend the medical status quo. Until relatively recently, there was no "medical establishment" as we understand it. A hundred or so years ago primary health care was administered initially by the immediate family, then by the wider community. "Doctors" were healers of last resort. With industrialization, the advent of the nuclear family, increased mobility and advances in medical technology, healthcare practitioners became, for many, the primary source of healthcare. The result, much of the time, was control of information and treatment by the practitioner. The "doctor" examined the "patient", analyzed the "symptoms" and prescribed a "cure". The "patient" dutifully took the "medicine" and reported back on its efficacy. Times have changed. Today we are much more conscious of preventative medicine, the benefits of a balanced diet, of exercise and the potentially harmful effects of substances like nicotine and animal fats. We are also much more aware of "alternative" treatments like acupuncture and homeopathy. Still, for many people, when something goes "wrong", they consult a doctor. What Health Online says is that, when something does go "wrong", there are resources of information, advice and counseling on the Web which can offer aid, succor, comfort and informationto the afflicted. Armed with knowledge, "patients" are better able to diagnose themselves and evaluate the most appropriate treatment - without the formal participation of a medical practitioner in the first instance. Our physical community can be augmented by a virtual community, global in reach and numbered in thousands or even millions. For example, sufferers of Chronic Fatige Syndrome (CFS) can subscribe to Cathar-M, a monthly eZine; participate in CFS-L, the CFS Discussion Group, receive CFS-News, a monthly e-newsletter; and get updates through CFS-Wire, a weekly digest of news articles. This is pretty radical stuff. It advances a totally patient-centered model of healthcare, with the physician assuming the role of facilitator rather than a dispenser of knowledge and treatment. The doctor becomes the "healing resource" of last rather than first resort. The social and economic ramifications of this are profound. For a healthcare system in crisis, this realignment of resources will be salvation. The "medical establishment", like it or not, will accept the dissemination of control and information and consequent evolution of a more educated and informed constituency. Interestingly enough the major purchasers of Health Online are members of the medical community. Dr Tom doesn't look or talk like a revolutionary. He's modest and self-deprecating. He likens himself to Martin Luther rather than Lenin - reformation rather than revolution. This book, he explains, is wide and shallow. Its successors promise to be deeper - case-studies of how MDs and lay people have used the Web to cooperate more fully in the diagnosis and treatment of "dis-ease". Now, where's Dentistry Online...? Health Online by Tom Ferguson MD is published by Addison-Wesley, price $17.00. Dr Tom's WebSite is at http://www.healthy.net/home/index.html John Blower Home © 1996 John Blower/FeNiKs