Intended for healthcare professionals

Rapid response to:


How Web 2.0 is changing medicine

BMJ 2006; 333 doi: (Published 21 December 2006) Cite this as: BMJ 2006;333:1283

Rapid Response:

Web 2.0 is About Ordinary People, Not Platforms

The crux of the author’s argument – that Web 2.0 is changing medicine – never seems fully explored in this article. Yes, while it’s interesting the doctor’s blogs – which have existed for at least 8 or 9 years – help people digest random little nuggets of information, I’m not sure how reading such information is changing medicine. New technologies like RSS add to my information overload, they haven’t readily reduced it.

If Web 2.0 is about collaboration, transparency and sharing, then its heart is clearly ordinary, everyday people. Companies are not at the heart of the power of Web 2.0, people are. So while a company like Google (which has only more recently embraced many of the core concepts of Web 2.0) is successful and popular, its future popularity may very well be reliant on a completely different model of innovative search – for instance, one powered by people, not computer algorithms. Wikipedia is popular not merely because it uses the wiki architecture, but because it also brings a sufficient quantity of people together in a single, unifying purpose. Arguably the best example of how Web 2.0 has made an impact in the world of medicine, The Flu Wiki, is missing from this article.

I have seen physicians joining the conversation and collaborative efforts more in the past few years than in the prior decade, largely because of the growing mainstream use of Web 2.0 tools in people’s lives in general. But people use Web 2.0 applications not because search engines are failing them (in fact, it remains the primary method of looking for health information online (1, 6)), but because the collaboration and sharing strongly speaks to humanity’s intrinsic social nature. If I contribute to Wikipedia or Digg, I do so because I want to be a part of a shared social conversation. The combined knowledge of hundreds or thousands of users is generally thought to be greater and more helpful than a single individual’s.

There are looming issues for the Web 2.0 community as well. Accuracy remains a concern for health information, since an important but incorrect notation can have significant consequences in a person’s care or treatment. Such incorrect notations have caused harm in the past (5), and there’s no evidence Wikipedia’s system has changed to catch future occurrences. While Wikipedia appears generally reliable (2), there remain concerns about its consistency and the variability of its information (3). Ratings from individual users remain biased and unscientific, but rarely do websites note that one should not draw conclusions based upon user ratings (4). What is of little concern when purchasing your next summer beach read becomes of greater concern when others will be making health care judgments based upon the data.

One of the true joys of Web 2.0 is how easy it is to begin today. You can edit, contribute and work on any article you’d like at Wikipedia instantly. No software to learn or download, and there’s no requirements for membership to become an editor. While efforts like the Public Library of Science’s online journals are an important step for open source journals, future online journals will go one step further – allowing anyone and everyone to contribute peer-reviewed articles at no cost. Because Web 2.0 has shown us that information can not only be social in nature, it can also be free to everyone.


1. Fox, S. Online health search 2006. Pew Internet and American Life Project. 29 Oct 2006.

2. Giles, J. Internet encyclopaedias go head to head. Nature 438, 900-901. 15 Dec 2005.

3. Grohol, J.M. Web 2.0: Consistency, Relevancy and Reliability—Blog. 25 Feb 2006.

4. Magnus, P.D. Epistemology and the Wikipedia. Presented at the North American Computing and Philosophy Conference. Troy, NY. 8 Aug 2006.

5. Seigenthaler, J. A false Wikipedia ‘biography.’ USA Today. 29 Nov 2005.

6. Tan H, Ng JHK. Googling for a diagnosis—use of Google as a diagnostic aid: internet based study. BMJ 2006;333:1143-5.

Competing interests:
None declared

Competing interests: No competing interests

08 February 2007
John M Grohol
Publisher, 01950