New Jersey is just not home yet for Bill Silberg, an editor and Chicagoan who spent 13 years at the American Medical Association and a previous three at the University of Chicago before moving East for a big job last spring. But he’s more than comfortable in his new territory as vice president and executive editor of Medscape, a leading Internet site for health professionals.
Silberg spent the last four of his Chicago years as editorial director of medical news and new media for the Journal of the American Medical Association (JAMA). Then he joined Medscape (and former JAMA editor Dr. George Lundberg) just under a year ago. That makes him a virtual veteran in editing and producing Internet sites.
“Medscape was started in 1995,” said Silberg at a recent “e-health” forum sponsored by Northwestern University’s Medill School of Journalism. “That’s old for the Web.”
Perhaps not so coincidentally, the mid-1990s is also the time when Americans started turning to alternative health therapies in record numbers and in higher volume than actual visits to the doctor’s office. Searching for information about alternative or complementary medicine on the Internet gives the consumer two frontiers for the price of one connection.
“There is more blurring between (what journalists call) church and state,” Silberg said. “The way we look at information on a computer screen is different. There are no firm policies in place to tell you what’s editorial material and what’s advertisements.”
Evaluating alternative medicine is a challenge for a site like www.medscape.com because Lundberg, Silberg and other editors insist on “evidence-based medicine” in which randomized clinical trials are the gold standard. Drugs and many medical procedures have been proven valuable by just such research methodology, but dividing subjects into placebo and experimental groups for alternative medicine studies doesn’t work as neatly.
For instance, it can be difficult to test the effects of massage therapy or aromatherapy without placebo subjects knowing they are not getting the experimental treatment. It’s no accident that herbal capsules (using dummy pills for a placebo) and acupuncture (in which the needles can be placed in neutral positions) are gaining the most favor with American doctors and medical researchers.
Silberg said Medscape is struggling with whether to start an overall alternative and complementary medicine site or focus on specialties with more proven research track records.
Other Internet sites, such as www.WebMD.com, which requires two staff physician-editors to approve any on-line story, have similar decisions to make about posting alternative medical information.
But that doesn’t mean there is not an alternative medicine avalanche on the Web. It simply remains a bit hard to figure out the snow jobs from the clear reports. A good place to begin any search is the National Institutes of Health site, www.healthfinder.com. It provides good background on alternative therapies, major conditions, and a valuable “Is it for me?” section that covers health-care centers, doctors, journals, potential quackery and fraud, and research.
Most useful are built-in, one-click links to other sites, including the NIH’s own National Center for Complementary and Alternative Medicine (NCCAM). Its “CAM Citation Index” lists 180,000 research references, pulling from the National Library of Medicine, which even the most stringent medical sites consider the bible of databases.
For now, it is important to remember all Internet sites need to be viewed with a critical eye. Look for health sites not afraid to link you to other locations in an effort to answer your questions.
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Equally important is to determine who is providing the information. The authority or source behind a site can tell you a lot about whether you are experiencing e-health advice or simply e-commerce.
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To contact Bob Condor or find an archive of his columns, visit chicagotribune.com/go/health
His e-mail is [email protected]