Wednesday, May 28, 2008

Blogger Beware

Just as the Internet is partially tainted by pop-up ads and untrustworthy sites, and email is almost ruined by spam, blogs are at risk for those whose primary interest is not necessarily for the good of the public. Though Web 2.0 technology, which blogs are a part of, increase the ability for individuals to connect and share information, there is also pleny of room for scams, sales pitches, and other forms of misinformation. This is particulary troublesome for healthcare/ medical blogs, since patients suffering from a particular ailment may be more susceptible to messages that promise a cure.
One of our recent medical school graduates, Dr. Fred Weiss, pointed me toward one such website/blog at

The premise does sound legitimate:

"This web site is designed as an aide in helping patients and their families address the concern of medical misdiagnosis. We built this as a place where people can share stories and learn from others’ experiences."

They even take efforts to state that they are not trying to blame doctors, but rather raise awareness, increase discussion, and hopefully solve the problem. Thus far there are two "posts" from "patients" who relate their stories of being misdiagnosed with cancer, and relieved to find out it was only an infection. You are similarly encouraged to post your own personal experience with misdiagnosis.

Here's the catch. There is one impressive looking advertisement on this "blog" for Premerus Diagnostic Excellence. Premerus is a diagnostics imaging site where physicians refer to local premerus imagining centers, and then the images are sent to a central site where the "Premerus Expert" interprets the study and communicates this back with the physician. Though it is not entirely clear why the Premerus radiologist is better than your local radiologist, the site touts that their product "increases diagnostic accuracy, improves patient outcomes, and decreases health care costs." The site also discusses the common problem of....(get ready)....misdiagnosis.
It took some very simple Internet snooping to easily discover that the owner of and Premerus Diagnostic Excellence is one in the same!!

I am sure that using a blog deceptively to promote some product is not new and will continue for as long as blogs exist. However, this is particularly disturbing since the Chief Medical Officer Gregg P. Allen, M.D and the medical director Norman Scarborough, M.D. of Premerus are both physicians. Though promoting health care services can be done in an ethical way, this deceptive way of using a medical blog is certainly an infraction of the ethical standards of the medical profession.

If you use the Internet, and medical blogs, in particular as a source for medical information, make sure to check on the source of information. Look at the "about" section to view the author's credentials. Look at who advertises on the site. Advertising is not inherently bad (I am up to $5 profit on my Google Ad for this blog), but look out for potential conflicts of interest. Finally, I believe the only way to solve this problem is to collectively police. If you find an unscrupulous medical blog, do more than just ignore it, call it out and warn others. This was my intent for this post.


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Anonymous said...

Dr Mintz

Just thought your readers would like a up date I have been Chantix
For 3 day know and I am doing ok. No bad dreams yet start taking 2 pills tomorrow
Also I want to thank you for the help on my husband. Talk at you soon

Dr. Matthew Mintz said...

that's great news!

Anonymous said...

Dr. Mintz

Well I have been on Chantix now for 9days know. Know really bad dreams.
But starting the 8th day I have had a headache on and off all day I am very sad not depressed just sad. Well it pass the headaches and sadness. Is this part of what happens
When you quite smoking.

ROB said...

Hello Dr,
I have been taking for the past week due to having my wisdom teeth surgically removed. Can i start my prescription of chantix while still taking vicoden?

Dr. Matthew Mintz said...

Rob, I can not give you specific medical advice over a blog without seeing you as a patient. However, in general, there is no known contraindication for vicoden and Chantix. That said, Chantix like any other drug that works on the brain can cause changes in mental function. Narcotics do this as well. In general, would use both together with caution. I would recommend you contact your regular doctor for more specific information.

Nurse Mary said...

Dr. Mint, My husband was on chantix for three months and didn't quit smoking but cut down from over a pack a day to about 3 cigarettes a day. He had NO unwanted SE.
He has fibromyalgia and cannot take neurontin or Lyrica due to bad SE with those. However, while on Chantix he had the very pleasant SE of being virtually pain free. No pins and needles in his hands/feet, no deep muscle pain, and no muscle spasms.
Has there been any studies of Chantix being used for neurological pain? Or use over a longer​period?
Thank you

Dr. Matthew Mintz said...

@Nurse Mary, I am not aware of Chantix being used for neurological pain, but it does stimulate areas of the brain to release dopamine, which is a substance associated with memory and mood. However, recent data suggest it may be involved with chronic pain. So, while I would obviously recommend consulting his physician, there is least a theoretical reason for Chantix to be helping.
As far as long term use, Chantix is really only meant for 6 months of treatment. However, given a very good safety profile (and because of some initial concerns, it has been studied extensively), long term use is probably safe in general.
Again, I would advise him to speak to his doctor to review all the pros and cons.