Peer to peer healthcare-- resources and personal reflections

The internet makes it possible for any of us to proactively manage health problems through research. We can locate facts, statistics, opinion, advice, experiences of others experiencing similar health problems, and academic and practitioner research. We can find this in a variety of media – print, video and audio.  How we go about the research and how we use what we find makes interesting study. There is no question I would be lost without the ability to comb the internet for research relating to a health problem. However, getting to a satisfactory solution or to the point where I can formulate possible solutions to my particular need and/or questions to discuss with a health professional can be very time-consuming. And in instances where research turns up innovative or non-traditional approaches to treatment,  dilemmas of choice, access, cost, trust and communication can make for a very frustrating experience.

As an example, here is a recent, health-related problem tackled by my family.  Last year my mother, in India, needed a hip replacement.  My sister in India checked with her network of friends and acquaintances in Mumbai for recommendations of surgeons.  She communicated that information via phone and e-mail to the rest of us situated in three different countries. Some of the doctors had websites we could look at.  After Mum saw the doctor, she was told she needed a total hip replacement and provided with options and costs of hip prostheses from which she had to choose one.  The choices were for oxynium, cobalt/chrome on metal, ceramic on metal, metal on metal, cemented or non-cemented, 28” or 36” or 44” head (!)   We had to make the choice in a day or two.  The initial response was to choose the most expensive – surely that would be the best?  However, upon drawing on our pooled knowledge and research (discussions with product vendors;  knowledge of products this doctor was most familiar with; information from sites like NOAH and the Mayo Clinic; product descriptions at vendor sites; power point slides by van Langelaan on clinical and economic aspects of cemented and cementless hip prosthesis;  and particularly the Australian Joint Registry summary statistics; and 10 year data from the New Zealand Joint Registry on revisions)  we decided that the most expensive was not the best option.  Based on the research and on Mum’s age and condition of her hip, we opted for a combination of poly and metal, cemented with a 36” or larger head.  It appears to have been the right decision. However, we could only have a 28” head as a 36” was not available (!?!).

A Pew Internet and American Life Project report of its Peer-to-peer healthcare (February, 2011) study offers some insights into the circumstances that influence consultation with health professionals and/or with peers.  The results are interesting, though not surprising.  The majority consulted a health professional with a health issue, a little over half turned to family and friends for support and about a fifth turned to others who had the same health condition.  A very small proportion of health consultation and support from professionals took place online.  Peer-to-peer interaction with family, friends and fellow patients was most helpful in matters of coping with illness, particularly when dealing with rare disease.