An article on the internet for doctors.
Dated.
So you thought that tending to people was more important than tending to dreary machines? Well, life has come full circle. In order to be a better healer, you will have to learn to co-operate with those same machines! So, why does Chip say that the Internet can make you a better healer, a better doctor?
This is the information age. Knowledge is power today, more than ever before. Today, to remain current and stay aware of happenings everywhere requires you to utilize all the resources that you have. Today, patients will read up on their conditions, look at alternatives, seek opinions and then come to you. All this they are able to do from the comfort of their home via the Internet. Therefore, for you to stay just that one bit(!) more informed, it’s vital that you too exploit all the potential that the Internet provides. If you need the Internet so much, how can you access it? ISP’s (Internet Service Providers), provide you a range of options to choose from. Phone the companies, look at pricing, access hours that you think you will use, after sales service. You will also need a fairly decent(!) machine because your specific needs of multimedia and other medical software are resource intensive. You will also need to setup your access to the Internet via the phone line, load the necessary software etc. Here is some general advice about the Internet. Compose email messages offline, spell check them and only then send. Always surf with graphics and sound options turned off. Turn them on only when you need to. Ditto with Java and Javascript. Set the security options in your browser to High security. Be very sure before you give anyone you meet on the Internet your personal details, name, address etc. Ditto with email address and login name, password etc. The Internet is not this real evil place, but if you get unlucky, … heaven help you!
The Internet IS the world’s largest library. It is can be subdivided as many interconnected networks of computers. These computers store (in the jargon host) documents that have a common method of specifying how their information should be interpreted. This method is known as the Hyper Text Markup Language (HTML). The documents are known as web pages, and the interconnected documents comprise the World Wide Web. Documents are cross-referenced by hyperlinks that allow you to move from one document to another. HTML documents and hyperlinks together constitute what is commonly known as the World Wide Web or just plain Web.
For you to view a HTML document you will need software that understands the HTML format. These software packages, known as browsers are generally graphical in nature with user friendly help and additional features. Currently the popular browsers are Internet Explorer, Netscape Navigator and Opera. Almost all the features on browsers are similar, so it’s very easy to use any of them. A browser has a set of buttons on the top of the browser, known as the toolbar. There is also a text entry box where you can enter the name of any site that you want to visit.
Let’s go through a simple exercise in surfing the net. For example, let’s assume that a someone’s told you about an interesting site that you should visit. You only know that the main address of the site is “mentalhelp.net”. This address is a URL (Universal Resource Locator). You enter this URL into the browser and if your Internet connection is working, the page should start to load up. You can watch the progress of this operation by looking at the status bar at the bottom.
Now that you are there, you see text and images on the screen. If you move your mouse around, you will notice that over some parts of the text (generally underlined and in blue!) or some images, the pointer becomes a hand. This means that that text is a link or more correctly a hyperlink into another document. So, continuing the example, you see a hyperlink titled Psychology. If you double click on it, it will load the Psychology page of the site mentalhelp.net. Now, if you wanted to go back to the main page, you could use the Back button. It takes you to the previous page that you visited. Similarly, a forward button is also present, which functions appropriately. The Print button can be used to take a printout of the page on a printer if it is attached to the machine. The Stop button can be used to stop the browser from trying to read the HTML document. If you follow the links appropriately, you will actually get the page that you are interested in. But, the page can get modified during the time you were at the site, you might want to press the Refresh button to reload the HTML document that has changed. If you want to visit a link without closing the current page that you are viewing, right click on the link. Now among the options that you are presented with, choose the option that will allow you to view the document in a new window. In this way, you will have two windows of your browser running.
If you get a URL wrong, your browser will give you one of many errors. None of these are particularly helpful, so be careful. A URL has no spaces in it, and it always uses only forward slashes. You could also use a browser to understand files that follow methods other than HTML. Actually in order to make it explicitly clear that you are using HTML, your URL should be of the form
rather than plain old where the HTTP stands for Hyper Text Transfer Protocol. If you could access some files from the same site using another protocol known as FTP (File Transfer Protocol) you would have to use
ftp://ftp.mentalhelp.net
Email is the most common form of communication on the Net. It is the digital or electronic version of a normal postal service. So, when you mail someone, the person gets the equivalent of a letter and he/she can reply to you. On the Internet that so easily spans countries and continents, there is a uniform scheme of addressing everyone. This address is an email id. But, what’s an email id? Consider a typical email id as an example:
kurup @ pes . edu
There are three main parts of this email id:
Kurup : this is the actual login name, or the person’s unique identification within the organization
Pes : this is the organization’s name
Edu : this is the class of organization. This category is also known as a top level domain. In order to understand the various top level domains see the accompanying box on domain names.
Email id’s are case insensitive. Your email id depends on your connection to the Net, and or where you decide to create your email id. If you use your ISP’s email account, then you are most probably using POP (Post Office Protocol) access. If you use an account from Hotmail or Yahoo, then that’s known as web based access. Before we look at what’s different between POP and web based access, let’s look at the things that are in common. You will always have a unique login name that forms part of your email id. Along with this you will have a password that will ensure that only you can access your email id. Please think of some imaginative password! All your incoming mail will be placed by default in a folder called your In-Box. Remember that email is only plain text. So, if you need to pass on some document or other file, you can attach it to the mail, as a file attachment. Since, email is only plain text, it CANNOT infect your machine with viruses. On the other hand file attachments are normal files and are therefore VERY dangerous. So you should take care with running / opening them.
So, you want to send an email? You will first need to know the complete email address of the person you are sending the message to. You then first enter who you want to send it to in the To: area. Then if you want to send a carbon copy of the mail to someone else you could use the cc: field. Each email has a Subject: field. Use this judiciously to concisely indicate what the email is about. This subject is the first thing that the recipient of your email will read. Let this give him / her an idea of what your mail is all about. In order to simplify remembering long email id's, email software allow nicknames to substitute email addresses. So, if you want to send mail to , but you known him as “ashwin”. You can now associate ashwin with that long email id. Every time you need to send him an email, all you have to do is just type “ashwin” in the To: field and the software will put in the rest of the email id! Most modern software also allow you to spell check you email before you send it. Every email that you sent is automatically date and time stamped. The person who receives it will be able to tell exactly when the message was sent.
In POP access, you connect to the your server, send your mails and download all the incoming ones to your machine. You can then read, delete, modify or reply to the mails you received at your own leisure, offline i.e. when you are not connected to the Internet. This method saves on a lot of money and valuable Internet time and is getting very popular. Examples of this type of email software include Microsoft’s Outlook Express and Netscape Communicator’s email access. Check the accompanying box on configuring your Outlook Express client.
In web based access, your email access is via the web pages of the site that is offering you the email access. Therefore, to read, reply or create any message you need to be connected to the Internet. All this method requires is a web connection and a browser for you to be able to check mail. Examples include Microsoft’s and Yahoo’s . To use web based email, you will first have to create an account. Go to the respective site and follow the instructions for new users. You will have to enter some details about yourself. Once this is done, your account will be created. To check your email, enter the address of the site that you need to visit into the browser. You may need to enter your email id and password at the start. From then, surf your way to the rest of the world that’s already email savvy!
Most of the time, chats tend to be a mechanism by which the Internet gets a little more interactive than email and browsing. As with most Internet applications, IRC( Internet Relay Chat) can be accessed either directly using a chat client or via a browser. An IRC server is a large computer on the Internet which allows people to access it, and communicate to other people using it. In order to organize the conversations, each IRC has channels. A channel is an area that is dedicated or devoted to a particular topic. People can therefore choose to enter channels that deal with the subjects of their interest. In order to uniquely identify yourself, you will need a nickname.
If you log onto an IRC server you will be provided with a list of channels. Channels are generally denoted by a channel name, an example of which could be #heart-disease. You can now join this channel. Once you do, whatever conversations that are deemed public that are now occurring between various people all over the world will appear on your screen. You could now argue, agree or debate on the topic that is being discussed. Your contributions can be public (i.e. visible to everyone) or private (i.e. addressed and received by only one other person on the channel).
If you want to access IRC using a browser, then sites like and chat.yahoo.com are probably where you should start out. If you are directly connecting to chats using an IRC client (IRC software running on your system e.g. Pirch, mIRC) then you will need addresses like chat.talkcity.com:6667 to locate the server of your choice. To search for specific channels you can use the facilities of the site to look around for any discussions that could be of interest to you.
As an example, consider a chat session at Yahoo. If you own an email id from Yahoo, you can use the same id(which now becomes your nickname) and password for chatting. If not, you will need to create an nickname with a password. Yahoo uses Java for chatting, so you may want to switch it on, if you have disabled it. At the main Yahoo chat page, you will see a link that is titled Health / Family. If you click there, it will yield a list of rooms that you can visit. A room is the equivalent of a channel. If for example you wanted to visit the chat on Alternative Medicine, you could click on the respective link. Once you enter the room, you will see in a large box, which holds the conversations occurring in the room. Just below this will be a text entry box that you can use to add your inputs to the conversations. On the right you will see the list of the people currently in the room. If you want to send a private message to anyone, just double click on the person’s nickname. It will open up a window in which what you type will only be visible to that person. If you wish to leave, there is an Exit option. In case of any difficulties, there is abundant help available online.
Some chat channels are structured around concept of time based meetings. In such an instance, either people on the channel meet almost at the same time everyday or the channel itself has invited some major personality to be online and chat with the rest of the world. For example, if you always wanted to talk to X, who is a world renowned authority on something that interests you, it just might be possible that you could get to chat with him even without leaving the confines of your home!
Newsgroups and Mailing Lists are a different form of chatting on the net. Rather than being interactive and real time, these methods of communication are discussions that are offline. In a newsgroup, people who are interested in a subject can write and submit articles dealing with it. Each article written by a person can be read by every other participant of the group. Thus, in this way the entire discussion that is taking place is stored via the Usenet. Using a suitable NNTP (Network News Transfer Protocol) client (e.g. Netscape’s Collabra) you can view and post articles. The great part about newsgroups is that it is very well organized. For example, a particular newsgroup is
Sci.med.diseases.cancer
We see that the top domain is “sci” which stands discussions related to science. The next domain of “med” details that discussions under this level deal only with medical postings. Similarly “diseases” and “cancer” are specifics domains within their preceding domains. This well structured organization allows you to quickly go to the discussion of your interest. If you use Outlook Express, it ships with a wizard that allows you to configure your newsgroup access very simply. The only thing that you need to do first is to find out from your ISP what your NNTP server’s name is. Web based newsgroups provide a means to access newsgroups from within a browser. An example is the site . Sometimes, some sites themselves provide discussion boards. These are very similar to newsgroups, but are not part of them. These are generally very subject specific and you can get there only by searching for them.
Mailing lists are the email equivalent of Newsgroups. However, they have no central organization or co-ordination. Mailing lists are a group of people who email each other, while discussing a particular topic. Now, there are specific web sites that are devoted to organizing and co-ordinating mailing lists. Sites such as , and are places where you can start looking for the lists of your interest. Liszt.com also stores information about newsgroups, so it probably is the first site that you should visit.
As an example, if you were looking for a mailing list on the thyroid gland, you could go to liszt.com. Once there, you will need to type thyroid and search. The site will throw up many options with hyperlinks to each one of them. If you click on them, the site will provide all the information that it has on that particular mailing list. This page will contain information on the list, instructions on how to join and other subscribe information. In this case, if you need information on the list, you will have to send to an email with the words
info THYROID in it. For additional help on subscribing, you could also send the word
help
to the same address. The list server will then reply back and ask you to send a subscribe request in a particular format. If you decide to subscribe, the list server will send you a confirm notice. This email will also have instructions on how to remove yourself from the list, if you need to. Examples for newsgroups and mailing lists of interest can be found in the accompanying box.
Finding information on the Internet is much more difficult that it seems. Every day, more information gets added to the Internet that you can imagine. No matter how detailed or specific your query, you will find someplace or someone who will help you. A search engine is a software that allows you to search the web for documents that are of interest to you. Examples of search engines include , , . These search engines are general and contain a lot of information. However, there are also medical specific engines such as and . These are a little more specific and will automatically reduce the number of false alarms that any medical centered search will produce. If you are unable to find any positives with one engine, you should try the other engines. Remember, even if you search for something today and found nothing, it does not mean that tomorrow you may not!
Most general search engines do not require you to do any additional registration before you begin to search using them. However, medical search engines such as medscape and medline do so. This registration is free and is a very simple process. So, the first thing that you could do, is to go to these sites and register with them. Once this is done, you have complete access to the resources at the site.
As an example, consider a situation where you are looking for information on pollen related allergies. You have to first think of a few key-words that are likely to be present in a document that would interest you. In this case, “pollen”, “allergy”, “sneezing”, “rashes”, “immune” could be possible alternatives. You should think of the words that could possibly sidetrack the search engine and eliminate them.
You will have to enter these words into the search engine. Generally for a search engine, these words are treated as case insensitive. What the search engine now does is that it compares all the documents that it has in its database with the key words that you supplied. If the words match, then it will signal that page as a hit, or a possible document that you could be interested in. Something that should be noted here is that if you type the words
Pollen allergy sneezing rashes immune
in this particular order, the words need not be in the same order, all the words need not be present in the documents that the search engine presents to you. These are some parameters help you refine a search. For example if you type (in some browsers)
Pollen AND allergy
The search engine will ONLY return documents that contain the word pollen and the word allergy. Read the accompanying box on Boolean Searches for more information. In order to further prune your search you could ask for
“Pollen allergy”
which will only return documents with the exact words “pollen allergy” in that order in them. A simple thumb rule is the following, if the number of hits you get with your set of keywords is too low, reduce the number of words and vice versa. Every time you submit a set of keywords to a search engine, the it will respond with a list of pages that it thinks are useful. You can then use this list of pages as an initial starting point for your surfing.
Each individual page in this list of hits will have short description of that page. This description is very useful and can save a lot of time for you. If you read this description, you can eliminate many false hits. The site address of where the document is stored will be present in the description. Study this too, simply because sometimes you may base your information only from reliable sources. It is also a good idea not to directly use this window for surfing. Use the right click, open each of the documents in new windows. This way, you can always get back to your search quickly if the first few pages are of no use to you.
Given that you actually reach a page that is of interest to you, you could do many things from there on. You could take a printout of the page, if you have a printer attached. You could save a copy of the page onto your machine. Note that the graphics and images will not be saved, so if you were looking for that electron microscope shot of E.Coli, well, you don’t have it down on your machine! You could also bookmark the site, so that it’s easy for you to return to this site, the next time you are online.
It’s also a useful idea to install a download manager like GetRight. This kind of software manages all the downloads that you will start. They also allow for downloads to continue even after the connection gets disconnected accidentally. Downloads are generally .ZIP, .PS or .PDF files. .ZIP files are files that have been compressed in order to reduce their size. In order to restore them to their original state, you need a utility like Winzip or Pkunzip. PS stands for PostScript while PDF stands for Portable Data Format. These are standards for describing graphics and text in an independent format. Most scientific documents, papers, survey articles and diagrams will be in one of these two formats. You will need the GhostView and Acroread software packages to be able to use these documents. It is a good idea to get these packages installed on your machine.
Apart from the many things that you can do on the Internet, there are many things that you should NOT do. A fine example is to capitalize words too much (E.g. the single NOT in the previous sentence would be ok!) because capitalization is the equivalent of shouting on the Net. Avoid directly contradicting or disagreeing with anyone. Even if you have to, try to put it across in as politely as possible. You may be talking to someone who is from another culture from the other side of the world. Even a simple joke to you could be a insult to him/her. When you just join a channel/mailing list, don’t immediately join the discussion. Wait for some time, watch what the people are talking about, get the hang of the atmosphere of the place before you take the plunge. Standing back and watching the happenings can be called lurking. This is also recommended for newsgroups.
This will save you a lot of embarrassment yourself if you actually did not understand the focus of the group when you joined it. For example, if a newsgroup(fictional!) was titled sci.med.diseases.lawyers and you assumed that it was about diseases that affected lawyers, well wait. It may well turn out that this is one of those newsgroups dedicated to intense lawyer bashing from all the frustrated doctors out there. They were probably referring to what a disease lawyers are (no offense intended!) , so beware!
To become part of the Internet, you will need to create your own home page. Creating your home page is a good idea, even if you are not too much on the Internet, or don’t check mail very often. Much like setting up your nameplate, a web page is the first step in creating your virtual presence (sorry!). Apart from allowing other people to be able to find you, it also lets you give to the whole world your unique and personal look at life, medicine and anything else in the universe. You can put up information, help and other details that people might want to know. This may make your page very valuable and very well known. You could also put up your photographs, your personal likes and dislikes, whatever. If you decide to create a website targeted at some people, and you do a good job, you could find yourself suddenly very popular!
Creating a web page first requires you to find a place that will store the HTML documents that form your page. This server is known as your host. Many free sites allow you to put up your homepage for free. These include famous sites like and . These sites also help you create your web page. All you have to do is to simply follow the directions from the browser. All you need to know is how to use the browser!
Another option is to use software like FrontPage or HotDog which are professional HTML editors. These software have wizards that completely automate the web page building process. You don’t even have to know a word of HTML and the software will take you through the whole process. The next step in the process is to ensure that the page is active and working on the Internet. Once this is done, you will have to advertise your page on as many search engines as you can. Remember, it’s not enough to add a web page to the Internet, it’s important to try and ensure that if someone wants to find you, he / she can. You could use visit counters and a guestbook to try to see who is visiting your page and why. Feedback from actual visitors is most important. Change your page occasionally, keep links current and fresh. There’s too much that goes into creating a good page to list it all here, one alternative is to read up on Web page design and web page creation. Check the accompanying box on the Frontpage wizard for creating web pages.
Teleconferencing and Internet telephony are new buzzwords. What this means for you is that you can communicate with people rather inexpensively irrespective of where they are in the world. In terms of technology, this means that simple voice communication is digitized and the communication medium shifts from telephone lines to the Internet.
If for example, there was this friend (or friends) or contemporary of yours that you wanted to talk to for his opinion on a particular issue. You could use the power of the Internet to work for you. You could set up a meeting wherein all the people could be in different time zones, in different parts of the world and yet discuss about the same topic speaking normally. You will need some hardware that will handle voice to data (and vice versa) conversion, but that is generally available along with any multimedia kits. For an inexpensive trial, try to get a microphone and speakers attached to your machine, test them and familiarize yourself with them.
Both you as well as your friend need to use software that can talk to each other (preferably the same) if both of you are going to use computers. An example of this type of direct communication is powwow . However, with software like Internet Phone, you could also call from a computer to someone on a normal phone line. You may need to pay for some of the facilities that are available, but comparatively these are very inexpensive. Once set up, you will need to arrange via email or otherwise some co-ordination so that both you and your friend are ready to communicate. Then you can chat, exchange voice messages, send or transfer files, have a virtual whiteboard on which you can exchange graphic messages or discussions. The sound quality on most of these software packages is not very bad and the delay is quite bearable. In any case, for the costs, this service is quite unbeatable.
An additional benefit of going online is that you can actually search for or advertise for jobs worldwide. Now, if you spent some time with a search engine, you can find that particular position in a medical facility that suits your particular combination of skills and experience. On the other hand, if you are looking for people to hire, then the Internet is a good place to get talent from anywhere to be able to directly talk to you. This is a very attractive reason to get that web site of yours up. For all you may know, someone could find your site and decide that you are the person that they want.
A doctor in New Zealand created history by offering the first remote consultancy practice in the world, using the concepts of information transfer via the Internet. An Indian site from Bombay is also part of the trend () by providing online homeopathic consultation. There are many more such sites planned, and many more doctors consulting online. Is this going to be the norm? Well, it’s difficult to predict the future. One point that cannot be denied is that distance does impose certain restrictions on personal interaction between a doctor and a patient. Whether medicine will benefit or suffer from such online consultation is yet to be proven. However, in the present, for many reasons, be careful when you either give or receive advice from people on the Internet. Without knowing who you are talking to, you could be atleast the cause for a minor incident, well upto the violator of local as well as national laws. Even if you incidentally prescribe some form of treatment and a person follows it, there could be serious repercussions. These could be serious offences in some countries or states even leading to prosecution and arrests. Many other countries may have rules and or regulations on the conduct of medical practice that is completely different from ours.
Even if you offer or accept advice, be very careful about any monetary aspects of the entire transaction. Do NOT at any point divulge any sensitive information easily to anyone, however genuine it may seem to you. Such information includes credit card numbers, bank accounts, tax information etc. This information could very easily be misused or could very easily be traced back to you. Be wary of any offers that seem too good to be true.
The saying goes, “on the net, you can be what you want to be”. People, institutions and sites that seem very legitimate need not be trustworthy at all. So on the Internet, it’s not just that only the paranoid survive, it’s that only the paranoid have a chance to survive. This is what was referred to before when it said that you should be able to judge information from the source that put it up. For example, no one can stop anyone from putting up a site with comprehensive statistics, data and information to prove the smallpox has not been irradicated. If someone is searching for information on smallpox and reaches this site, he / she could be tempted to believe that the site has information that is complete accurate and up to date. So, did you read some very official looking statistics on a new treatment? Treat it with healthy skepticism. Read some alternative methods on an old fashioned method? Treat it with lots of healthy skepticism. In fact if you are reading this online, and you got the message that trying to be put across then you should treat this document with wariness too. One can never take enough care. “Prevention is better than…” is a line is not news for a medico!
Why is it important for doctors to be online? Simply because the more legal and honest doctors there are around, the less chances there are of a quack getting away. Today, on the Internet you can get mail order solutions for everything from corns to cancer. A doctor online in a chat forum may not directly change the world. He / She may just add that one line of information that ensures that some quack somewhere else in the world has to answer questions from an angry patient. Every doctor online is another body blow to fake companies, treatments and policies that swarm the Internet and that threaten the lives of innocents.
After all, what else does the Hippocratic Oath expect of doctors? To provide the best treatment that can provided for the patient by the doctor. It was conceived in a time when the Internet was not just impossible, but beyond the realm of imagination. But, doctors today too, have to live and practice their calling by this very Oath. In the changed circumstances, each one of us have to do whatever we can. So, even if the patient is someone who you may never see, you owe him a debt if you let him suffer due to his ignorance and your passiveness. If the Internet is the medium by which a life was saved or some suffering was reduced, so be it. We are all more blessed for having being part of it.
These are the top level domains that are commonly accepted today. Many more are being planned. These will give you a rough idea of what the site’s URL is trying to convey and or the status of the site.
.com commercial site that generally stands in for a company site
E.g. www.sony.com
.org organization site, generally stands for large organization that is associated in some way with the site
E.g. www.ieee.org
.net network site, generally stands for a network or ISP
E.g. www.freshmeat.net
.edu education institution site, most US universities and other educational institutions work under this domain.
E.g. www.yale.edu
.gov US government, most official sites that belong to the Federal government
E.g. www.whitehouse.gov
.mil US military, if anything else is added here it is secret!
E.g. www.pentagon.mil
.in Indian domain name, actually to be used with every site that is based in India.
E.g. www.tatainfotech.co.in
some additional lower level domains specific to India are
.vsnl.net.in Old VSNL domain, now .vsnl.com
.satyam.net.in Satyam domain
.ernet.in ERNET, most educational institutions in India are on it
Outlook Express comes with a very useful wizard with which you can set up your account very quickly. To use the wizard start Outlook Express.
Click on Tools > Accounts
Click on the Add button and select Mail
Enter your name in Display Name, click Next
Enter your email address, click Next
Select POP3 as the Incoming Server and enter the POP3 server name, click Next
Type your only login name, and your password in the appropriate locations click Next
Choose the method of access via your ISP, click Next
Choose how you will establish your Internet Connection, click Next
Click on Finish and Close
Log on to the Internet as per step 8, and check mail!
These are some of the newsgroups under sci.med. Some additional medical related newsgroups that are present in the alt.med category are also listed.
Sci.med. AIDS: treatment, pathology/biology of HIV (Moderated)
Sci.med. All aspects of cardiovascular diseases
Sci.med. Dentally related topics; all about teeth.
Sci.med. Medical/scientific aspects of immune illness.
Sci.med. Obstetrics & gynecology. (Moderated)
sci.med. Repetitive Strain Injuries (RSI) & job injury issues.
Sci.med. Orthopedic Surgery (Moderated)
Sci.med. Pathology and laboratory medicine.
Sci.med. The teaching and practice of pharmacy.
Sci.med. Dialog and news in psychiatry and psychobiology.
Sci.med. All aspects of radiology.
Sci.med. Human vision, visual correction, and visual science
alt.med. Helping people with allergies
alt.med. Fibromyalgia Fibrositis List
alt.med. Discussions of treatment of paralysis/paraplegia.
These lists are only a small sampling of the 8000 lists available at liszt.com.
ACCRI-L : Anesthesia and Critical Care Resources on the Internet.
ANEST-L : Anesthesiology Discussion List.
ccm-l : Critical Care Medicine mailing list.
med-jokes : Medical Humor Among Health Care Personnel.
smartdrugs : The one and only Smart Drugs / Nootropics Discussion List.
SPIRAMED : Spiritual Implications for Medicine and Psychology.
WARN-L : Discussion list on antibiotics resistance.
Many search engines allow you to use boolean statements or connectors during your search in order to filter the sites that are being presented to you as hits. For example, the following boolean phrases are most commonly available on search engines:
AND : This forces both search keys to be present in a document.
A plus sign before a word also performs the same function.
OR : This forces atleast one search key to be present
NOT : This forces that the document does not contain the word
A minus sign before a word also performs the same action.
The first thing that you could do is to determine what is the default connector used in your search engine. For example if you are looking for information on muscle tears that are not fracture related and type:
Muscle tear
You will be given a list of sites that contain the word muscle OR tear or you will be given a list of sites that contain the word muscle AND tear, depending on whether the default connector is OR or AND. To further filter your search, you can enter.
Muscle AND tear AND NOT fracture
This translates into documents that have the key words muscle as well as tear, but not containing the word fracture. This following sentence also has the same meaning.
+muscle +tear –fracture
If the sentences described above returned too many hits with documents in which the words muscle and tear were separated and not together and therefore of no interest to you, you could now try
+”muscle tear” -fracture