6 warning signs that online health information may be unreliable

If you are using Dr Google to find information about a health problem – like most people do – you will come across unreliable information. Here are 6 warning signs that will help you stay clear from quackery sites.

Information may simply be outdated or incomplete. But sometimes it is deliberately incorrect or manipulated, for example to make you buy something. How to differentiate between the good and the bad? (I admit, this is not always easy).

#1: The site wants to sell something

If a website is trying to sell a product, the information provided may not be objective. Be careful if the site is:

  • Showing lots of advertisements or testimonials, difficult to distinguish from the website content
  • Offering a free trial, money back guarantee or special offer
  • Using phrases or words like: Recommended by doctors, used by professionals, scientifically proven, patented technology, or guaranteed results.

A site may not explain that its main purpose is to sell something. Stay clear if it sounds too good to be true, for example if the website is promising you a miracle or magic cure, amazing results, or a new, quick or easy way to fix your health problem.

#2: It is not clear who makes the claims

Always check if a trustworthy health professional or professional organisation is providing the online information, like the Royal Australian College of General Practitioners or Physicians, the Australian Medical Association, the Consumer Health Forum of Australia or the National Prescribing Service.

Are links to original sources or scientific research provided? Missing or insufficient information may be a clue that a website is not reliable. Websites carrying the HON Code or HealthInsite logos are usually reliable.

#3: The website is out-of-date

Always check how old the information is. Has the website recently been updated? If the information is more than 2-3 years old it’s best to look for a different source of information – or talk to a health professional.

#4: The site has a less reliable domain

Trustworthy health websites contain the domains .gov, .org or .edu, indicating that the information comes from the government, a not for profit organisation or a university.

This doesn’t mean that other websites are always unreliable, but it’s good to find out who is sponsoring or paying for a commercial website (.com or .com.au) before relying on the information. You particularly want to know if the information favors the sponsor.

Websites written by a single person are less reliable than websites run by professional organisations. Yes, that includes this blog (I just shot myself in the foot, didn’t I?)

#5: You have landed on Wikipedia

Wikipedia scores high in search engines so it’s easy to arrive at a Wikipedia page. As much as I like Wikipedia, one study showed that it may contain errors.

#6: The site is requesting your information

Reliable health information is freely available online (at no cost), so there is no need to give a website your details, like your email address. If you must submit personal information, check what will happen with your details first.

Look for the website’s Privacy Policy: this tells you how a website or organisation manages your personal information. You may want to know if your data will be sold or provided to other organisations. A Disclosure Notice informs you if a site receives funding or accepts forms of paid advertising, sponsorship, or paid topic insertions.

More information

A rule of thumb: Don’t rely on one source. Try to find other reliable websites or sources confirming a message or claim about a product or service. Ask an AHPRA-registered doctor or health professional if you’re not sure.

If you would like to know more about finding reliable health information online, have a look at this 16-minute tutorial by the US National Library of Medicine.

Sources:

Wrap-up: 3 things I have learned from #AHPRAaction

And so the AHPRA Action came to an end this week. The Medical Board announced on Wednesday it would work with the other Boards to change the advertising guidelines.

The media statement“(…) practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do NOT have control.”

Hats of to the Medical Board and AHPRA for listening to the feedback. I have learned three things:

#1: We now all know the rules

The media attention and focus on the law and advertising guidelines has made the road rules clearer than ever. Testimonials mentioning clinical care & used in advertising are out, and unsolicited comments including thank-you’s are in. Of course we will have to wait for the final revision, but it seems we all know where we stand.

#2: Consumers and health care professions united

The controversial advertising guidelines united not only health professions, but also consumers and professionals. This should happen more often. Some have already raised ideas to bring the health care social media community together on a more structural basis – watch this space.

#3: Big government should involve stakeholders

Consumer health advocate Anne Cahill Lambert noticed that AHPRA had not received consumer submissions during the guidelines revision. In this Crickey Blog she wrote: “Genuine consumer participation is sometimes difficult. But it should not be dismissed out of hand because of its difficulty.”

AHPRA has already started engaging and listening via Twitter. Here’s hoping that AHPRA will genuinely engage all stakeholders during future guidelines and policy revisions – without further increases in registration fees of course.

New AHPRA Action campaign kicked off on Change.org

The AHPRA Action campaign has stepped up a notch. Medical Observer is now media partner, the protest action has a new logo (see image) and a new public petition kicked off yesterday.

A Parliamentary Inquiry found that the National Registration and Accreditation Scheme, managed by AHPRA “remains a large and complex bureaucracy with potential confusion over lines of responsibility and accountability.”

AHPRA’s new advertising guidelines are exposing Australian health professionals to unnecessary risks and create more red tape and confusion.

AHPRA regulates over 600,000 Australian healthcare practitioners and charges registration fees. Lawyers said about the new guidelines: “(…) the very broad wording in paragraph 6.2.3 of the updated advertising guidelines potentially exposes all health practitioners to a risk of breaching section 133(1)(c) of the National Law.”

Enough is enough – the advertising guidelines must be changed.

Sign the petition here

EDIT 28/03/14: SUCCESS! THE MEDICAL BOARD ANNOUNCED ON WEDNESDAY THAT IT WILL CHANGE SECTION 6.2.3 OF THE ADVERTISING GUIDELINES. THANK YOU FOR TAKING PART IN THE AHPRAaction CAMPAIGN!

AHPRA’s guidelines: Can someone tell me what just happened?

The Australian Health Practitioner Regulation Agency now says in its new guidelines that practitioners can be fined if patients post online testimonials praising the clinical care they received.

Last Friday, it seemed as if AHPRA had backed down on the harsh regulation. But is this really the case?

What does AHPRA say?

First of all, here’s a quote from the current guidelines:

a review (…) that states ‘Practitioner was quick to diagnose my illness and gave excellent treatment’, is a testimonial which references clinical care and is considered in breach of the National Law.

The guidelines also state that health practitioners must take steps to remove unsolicited testimonials appearing on any (social media) website not under their control. However, last Friday the medical board put out a media statement on the AHPRA website saying this:

The advertising guidelines apply to testimonials in the context of advertising (…) there is a clear difference between advertising – which requires an intent to promote the health services – and unsolicited online comment over which practitioners do not usually have control (…). The Board recognises that practitioners are unable to control what is written about them in a public forum.

The full statement can be found here.

3 unanswered questions

Indeed, this sounds a lot better than the official advertising guidelines – the medical press have used the words ‘backflip‘ and ‘backdown‘. However, the guidelines have not been updated, which leaves the following three questions unanswered:

1. If a patient posts a comment on my Facebook page stating that I gave excellent treatment, this is still considered in breach of the National Law according to AHPRA’s guidelines and I may be up for a fine if I don’t delete this friendly post. Will I be able to defend myself by referring to the media statement posted on the AHPRA website on 7 March 2014? If AHPRA is serious, the guidelines should be changed in accordance to their statement.

2. Health professionals need to know why our feedback about exactly this issue has not been taken on board in an earlier stage. The first draft guidelines appeared in 2012 and health practitioners were not impressed. The rules were already clear: we knew that testimonials in advertising are a no-go (and I don’t mean unsolicited Facebook comments from patients) – and of course this applies to websites, social media, the classroom, the elevator and anywhere else.

In AHPRA’s udated draft guidelines (2013) the issue of patient feedback vs testimonials had not been addressed, which again led to a storm of online comments as well as another lot of official submissions. See also this post (April 2013). As we know, the final version was published last month and positive patient feedback is not allowed, but then again on Friday the board seemed to think that patient comments are not advertising.

3. As the advertising guidelines are common to all national boards (e.g. dental, nursing & midwifery, psychology etc) we need to know if and how the statement by the medical board will be applied to the other 13 disciplines.

I’m happy with the clarification by medical board chair, Dr Joanna Flynn, and I agree it is a step in the right direction. But it still seems unnecessary government interference, and, after three revisions, the guidelines leave important questions unanswered.

AHPRA’s draft social media policy

The 2012 draft social media policy by the Australian Health Practitioner Regulation Agency (AHPRA) caused a lot of upheaval. Health professionals expressed concerns it was too prescriptive. Now there’s a new version and the organisation is requesting feedback.

A 76-page consultation paper has been posted on the AHPRA website and it includes drafts of the social media policy, revised Code of conduct, revised Guidelines for advertising and revised Guidelines for mandatory notifications.

It looks like AHPRA has taken the feedback on the earlier version on board. The new draft Social media policy is less prescriptive. Health professionals have to follow strict professional values, no matter if they’re in the elevator at work, the pub, or on Twitter or Facebook.

What does it say?

Most of it is common sense, but I thought these two changes were worth mentioning:

  • Health practitioners are expected to behave professionally and courteously to colleagues and other practitioners, including when using social media (Code of conduct 4.2c).
  • Testimonials on Facebook and other social media networks have to be removed by health practitioners (Guidelines for advertising 7.2.3).

I’ve read all 76 pages but it’s not entirely clear to me what exactly a testimonial is and whether I’m now required to remove my LinkedIn testimonials and endorsements by colleagues from around the world.

Also, it will require some explaining when removing or refusing friendly, unintended testimonials from our patients on e.g. Facebook, and worse, it may even put health practitioners off social media. I won’t mention Google testimonials – they are impossible to remove. It would be great if AHPRA can provide some clarification and reassurance here.

Interestingly, an issue that causes heated debates has not been mentioned, namely anonymous posting on social media networks by health practitioners who are identifying themselves as such, but are using a pseudonym instead of their real name. Some say it’s important for e.g. whistleblowers to be anonymous, others say health professionals always have to be identifiable. But perhaps it’s a wise decision by AHPRA not to open this can of worms.

Good or bad?

The problem with regulations like this is that it increases liability for health professionals and practices already operating in a highly regulated industry – especially against a backdrop of the recent national eHealth developments and the legal issues that health providers are facing when signing up for the PCEHR. Some of the risks are: less innovation and progress, a defensive attitude by practitioners, higher legal and insurance costs, increased AHPRA fees and eventually more costs for patients.

That brings me to the risk management paragraph in AHPRA’s draft Code of conduct, which states that it’s good practice “to be aware of the principles of open disclosure and a non-punitive approach to incident management”. I wonder if AHPRA is going to follow this advice when a practitioner breaches a social media clause. Something tells me that the regulator will follow a punitive approach if we forget to delete Mrs Jones’ friendly Facebook recommendation.