Ask a Cyberdoc

By Christine Gorman

It never fails. You're sitting in your doctor's examining room wrapped in a paper gown. You've asked every question you can think of and tried to absorb the rapid-fire answers. But when you get home, you realize there's one maybe-not-so-urgent item you left out. Do you a) call your doctor's office and play telephone tag for the next three days, or b) log on to the Internet and seek out an online physician?

If you picked b, you've got lots of company. In the past few months, everybody from world-famous hospitals to cyberentrepreneurs has added an Ask-the-Expert feature to his health and medical home page. And judging by the crowd at Intel's Internet Health Day in San Francisco two weeks ago, the boom is just beginning. Flesh-and-blood doctors may cringe, but today's online health advisers are giving us a glimpse of the future of medicine.

First, a few rules to live by. Don't fire up your modem if you're experiencing chest pains or some other medical emergency. Get thee to a hospital. Don't expect online doctors to diagnose the rash on your baby's bottom--that would be unethical, not to mention dangerous and probably illegal. Do find out who's sponsoring the site, how secure it is and what will become of your information. Double-check what you learn with your own health-care provider. And read the disclaimers.

Consider my experience with America's Doctor Online, which was launched last month on AOL. The service (keyword: amdoc) provides free access to a real-time electronic chat with one of about 40 M.D.s 24 hours a day, seven days a week. The brainchild of Dr. Scott Rifkin, an internist who practices in Owings Mills, Md., America's Doctor Online offers a small library of medical information. For more complete resources, check out the American Heart Association www.amhrt.org or the Mayo Clinic www.mayohealth.org)

The first thing I am asked to do when I log on to America's Doctor Online is wait. "There are 32 people ahead of you," the screen says. Pretty realistic, I think. Next time I'll bring a magazine. Ten minutes later, I'm in a one-on-one chat with Amdoc4. I ask him one of my standard test questions: "Why don't my HDL and LDL numbers add up to my total cholesterol number?" And he answers, correctly, that there are other factors like VLDL in the mix.

When I ask whether it's important to know my VLDL count, he says no. In fact, that's open to interpretation, since one of VLDL's jobs is to carry fatty substances, called triglycerides, in the blood, and some researchers think triglyceride levels may help determine heart-disease risk. Amdoc4 nails the next question about HER-2/neu, the defective gene that's been linked to aggressive forms of breast cancer.

America's Doctor does a good job of protecting your privacy. The doctors can't even see your name. Other websites make you post your questions in public forums.

But the best site I visited, by far, was one available only to 15,000 members of the Kaiser Permanente HMO (I had a guest pass). When you ask nurses there a question, they can access your medical record to help inform their reply. Kaiser plans to offer the ultrasecure, password-protected website to all its 9 million members next year. What will they think of next?

For a review of other websites, see time.com/personal You can e-mail Christine about this article at [email protected]