The Internet as Practice Extender

Medscape www.medscape.com is tailored for medical professionals with original, peer-reviewed reports and journal articles organized by medical specialty. (Many sites, such as Medscape, require users to register before they can fully access the site and its resources. Registration is usually completed with an online form, which entails the user entering some basic information [e.g., e-mail address, name, password, etc.]. Although many sites are free, some sites charge for part or all of the resources offered-Ed.) Medscape offers an extensive compilation of medical conference news summaries, treatment updates, original medical texts available in electronic format, clinical research on MEDLINE and category 1 credits. If you are unable to attend a conference, Medscape even provides next-day conference summaries written by medical specialists.

Medscape's psychiatry page includes sections for psychiatric news, journals, treatment updates and conference summaries from the 1999 American Psychiatric Association meeting. The clinically focused conference summaries offer up to eight hours of free CME credit. I found the Medscape conference summaries very well-written. They included discussions of combination therapy in depression, childhood-onset schizophrenia, and new frontiers in the assessment and treatment of dual diagnosis.

Also available through Medscape are patient monographs, which can be handed out to patients for medication information and side-effect profiles. To test the search capacities, I plugged in the phrase new antipsychotics. Medscape then produced a very useful document entitled "Atypical Antipsychotics: A Practical Review."

Medcast www.medcast.com is a medical news and information subscription service designed to meet the needs of physicians. This site provides daily headlines, pharmaceutical updates and research articles for a variety of specialties, including psychiatry. Medcast features professional writers who monitor medical journals, professional organizations, and legislative and regulatory bodies to generate original content for subscribers daily.

WebMD www.webmd.com began as an Internet portal for consumer health news and information. WebMD now has over 54,000 physician subscribers. There are physician directories and condition-specific "communities" that serve as support groups for patients. WebMD has a specific psychiatric site, but it is not as robust as Medscape Psychiatry.

WebMD also features reference materials including patient education, The Merck Manual, and Diagnostic Procedures and Medical Software reviews. Literature searches and journals are online as well. Patient information handouts prepared by Clinical Reference Systems are available for behavioral health, including major psychiatric illnesses.

Many professional medical organizations have Web sites that offer membership information, news, clinical updates and meeting calendars. Popular destinations include the APA www.psych.org andthe American Medical Association www.ama-assn.org.

Utilizing the power of e-mail for dissemination of information, the APA has launched an online news service, APA On-Line News. This e-mail newsletter covers legislative developments, changes in Medicare rules, managed care guidelines, annual meeting updates and Board actions. APA members can sign up for this newsletter at www.psych.org/apamember/onlinenews.html.

The American Academy of Child and Adolescent Psychiatry www.aacap.org has a very useful listing of informative handouts called "Facts for Families." The Academy has posted these for public release and distribution of information on child psychiatry including illnesses, medications and family issues.

The U.S. government, after playing a primary role in the founding of the Internet, remains a major online presence. The National Institutes of Health Web site is located at www.nih.gov. The National Library of Medicine www.nlm.nih.gov has a nifty gallery of images from the history of medicine. In addition to making press releases, the National Institute of Mental Health www.nimh.nih.gov provides patient education programs for a variety of conditions. The NIMH Web site's Anxiety Disorders Education Program starts with a patient anecdote of what it is like to live with the disorder. This site is a good example of an Internet resource to which psychiatrists can confidently refer patients for information about their conditions.

A further demonstration of the value of the Web for drug alerts and information can be found at the U.S. Food and Drug Administration site www.fda.gov. Adverse effects of medication can be recorded at www.fda.gov/medwatch.

CME LLC, the parent company of Psychiatric Times, offers continuing medical education credits on its Web site, Mental Health Infosource www.mhsource.com. Informative articles are posted from current as well as previous issues of PT, Medicine & Behavior and other publications. Mental Health Infosource includes MHinteractive, where questions can be posted for experts, and Healthier You, which provides consumer information on mental health conditions. Mental Health Infosource has subsites on schizophrenia and bipolar disorder for even more condition-specific information.

Of all the Web sites I reviewed, one of the best CME activities on the Internet is at Mental Health Infosource. Progress in Psychopharmacology: Psychiatric Disorders Update is an online course that offers up to five category 1 credits. The course starts with an excellent review of basic receptor/ligand biology. The graphics that accompany the text clearly illustrate signal transduction and receptor-specific neural pathways. The review of serotonin biology and the serotonin/dopamine interaction in this CME activity is very well done. This illustrates the true potential of the Internet for continuing medical education.

The growth of medical resources on the Internet has been phenomenal. In the future, the Internet may be at the core of many physician-patient transactions, including claims processing, lab orders, medical record access, transcription services and even supply orders. With so many rich and informative Web sites, it is impossible to describe the abundance of psychiatric resources online. It's time for all psychiatrists to get on the Internet and experience the bounty for themselves!