“eMedicine”

Leprosy Mailing List, September 8th, 2008

Ref.: “eMedicine”
From: Frankel R. I., Hawaii, USA

Dear Dr. Noto,
With all due respect, I must take issue with Dr. Compostella's statement "eMedicine is the leading provider of clinical medical information for medical professionals and consumers." (LML Sept. 6th, 2008). It is but one of many sources of clinical medical information, and I certainly do not consider it the leading provider.
I am sure many readers of your list will disagree with statements in this article, such as "The fluid is placed on a glass slide and stained by using the Ziehl-Neelsen acid-fast method or the Fite method to look for organisms." One should certainly avoid the Ziehl-Neelsen stain because of the risk of a false negative result. One can take issue with other statements, but I am writing less to criticize this paper than to caution readers regarding Dr. Compostella's statement.
The lead author of this eMedicine paper is a resident. I have great respect for residents and spent most of my career actively teaching them. I served as Program Director and Deputy Program of the University of Hawai'i Internal Medicine Residency Program. Yet resident are learning and gaining experience and generally have very limited clinical experience and a limited perspective. I was very surprised in the early days of eMedicine when one of my residents told me that she had written a chapter for eMedicine. Residents can certainly do extensive reviews of the literature, yet that does not generally suffice for broad expertise that includes knowledge of more obscure literature, knowledge of data that has been presented but not published, and clinical and research experience.
Thank you.
Richard I. Frankel, M.D., M.P.H., F.A.C.P.Emeritus Professor of MedicineUniversity of Hawai'i