A CCORDING TO RECENT RESEARCH BY THE NON-PROFIT PEW Internet & American Life Project, seventy-nine percent of internet users have searched online for information on at least one major health topic. That translates to about 95 million American adults using the internet to find health information, or about 8 to 9 million Americans on any given day. The Pew Internet & American Life Project's previous research found that online health seekers are often motivated to search out information that relates to actions they might need to take for specific health issues in their lives. For instance, they (or people they love) might have experienced health symptoms that worry them and internet users search for information about whether they would be wise to visit a doctor. Or, they might have just received a diagnosis and want to learn more about their particular condition. In many cases, online health seekers are action-oriented and highly purposeful, because there is a pressing medi- cal issue for them to address. If that issue is something that chiropractic care can address, how likely is it that the internet user will find accurate, positive information on chiropractic that will encourage them to see a chiropractor? The answer to this question could have a far greater impact on the future of chiropractic than one might expect. In order to understand why, we must look at what internet users are doing online. The Pew Internet & American Life Project's research found the top five activities of internet users searching for health information are as follows: Tentatively diagnose their own diseases Confirm their doctor's diagnosis and suggested treat ments Check their doctors' credentials Research all available treatment options—not just those recommended by doctor Give themselves a crash course on a specific medical condition when they (or someone they love) is diagnosed Clearly these activities indicate a decision is being formulated on a course of action. This is precisely the time when accurate, positive information on chiropractic care can have the greatest impact. The internet provides, for the first time in history, the ability to reach those in need of care at the exact moment they are deciding the form that care should take. Imagine sitting outside a physician's office and being able to speak to each patient that has been given a prescription for pain medication for low back pain and present to them chiropractic care as an alternative form of treatment. Better still, let's say that you mainly speak only to those that are less than comfortable with the physician's recommendations and are looking for other options. In many ways, this is precisely the opportunity at hand. So, how well is the chiropractic profession currently represented on the internet to take advantage of this opportunity? You can see for yourself. Using Google, the world's leading search engine, perform a search on the term "chiropractor." What you find should cause you great concern. As of this writing, a Google search on the term "chiropractor" returns a Bureau of Labor Statistics overview of "a career as a chiropractor" as the number one result. The second result is a condemnation of the profession titled "My Visit to a Straight Chiropractor," by Stephen Barrett, MD, on his website, Chirobase.com, which is dedicated to disparaging chiropractic. The third result is another damning article on this same site. The fourth result is even worse. Because it is titled "Tips on Choosing a Chiropractor," for the average internet user, it may be the most appealing choice of all the results returned. It includes a "Chiropractic Referral Directory" and mentions both a national and a Canadian association. At first glance, it appears to provide helpful information on finding a chiropractor. As you read past the second paragraph, it becomes a full-scale assault on all "chiropractors who purport to diagnose or treat subluxations". It is, in fact, another anti-chiropractic Stephen Barrett website called Quackwatch.com. And the remaining results arc not much more encouraging. The current sixth result returned, Al-lExperts.com, is a site that boasts to be "the oldest & largest free Q&A service on the Internet." This is a forum for internet users to post questions that are answered by licensed experts in a variety of disciplines. There are currently eight chiropractors registered to respond to questions relating to chiropractic posted by internet users. A review of the recent questions and answers reveals that one of the chiropractors uses this as a forum to "educate" the internet users posting questions on the straight vs. mixer philosophical differences within the profession. This doctor is very passionate about his philosophy of chiropractic and chooses to preface most responses with a short dissertation on his definition of non-therapeutic straight chiropractic along with some history on the differing beliefs within the profession. But many internet users arc testing the water, so to speak, by asking a question in this chiropractic forum. They may be considering utilizing a chiropractor and need gentle reassurance and encouragement to take the next step. This is probably not the ideal time to point out inconsistencies in modalities and philosophical differences. For someone who has never been to a chiropractor, this may serve to reinforce the damaging stereotypes propagated by chiropractic's detractors. Let us look at it another way. What if an internet user has just been told by a physician that they suffer from sciatica? We know that four of the top five activities most frequently performed by internet users seeking health information relate to a particular diagnosis. A Google search on this condition returns exactly zero results that mention chiropractic care as a treatment option. Surely, since many chiropractors treat "back pain," there will be many results from a search of this term, which provide accurate, positive information about chiropractic. Think again. Not in the first 198 results displayed. The AC A website appears at 199, as of this writing. And, guess what is among the first 125 results: Quackwatch.com by Stephen Barrett. Term after term, condition after condition the results are the same. Except for an occasional sponsored link, there is no mention of chiropractic in the search results for any of a myriad of conditions for which chiropractic has been proven safe and effective. And these are just the musculoskeletal conditions. Looking beyond to terms and conditions associated with wellness, maintenance or preventive care, and even the occasional sponsored link becomes non existent. So what can be done to correct this and to take advantage of the opportunity described in the beginning of this article? A consumer oriented site, providing positive, accurate information about chiropractic would lay a foundation on which to build. Provide valuable patient education material on specific conditions for which chiropractic is effective. Use detailed graphics and animations to educate internet health seekers on spinal anatomy and the composition and function of the skeletal and nervous systems. Demonstrate how proper spinal care, hygiene and maintenance greatly impact overall health and quality of life. Explain the many degenerative diseases associated with neglect of the spine, the drugs and surgeries used to treat them, along with their sometimes-disastrous side effects. And, most importantly, demonstrate the important role chiropractors play in analyzing and correcting spinal problems. Provide content designed to be "found" by the major search engines, when an internet user searches for information on chiropractic as well as specific disorders. Combine this with search engine optimization techniques and a paid search campaign and reaching those in need of care at the exact moment they are deciding the form that care should take is an achievable objective. Presenting chiropractic in a positive way to online health seekers who are action-oriented and highly purposeful because they have a pressing medical issue to address will dramatically increase both awareness and utilization. Then, with a repository of valuable consumer information available and easily found by internet health seekers, begin to drive people to the site rather than sit passively and wait for them to come. Utilize a world-class public relations firm to facilitate national exposure throughout all news outlets: internet, television, newspapers and magazines. These very same public relations firms have successfully turned lackluster drugs into household names. Then, with this strong foundation in place, run cutting edge television and print ads that reinforce the message. This is a three-tiered approach, utilizing advanced internet technology, world-class public relations and creative advertising. With the food, beverage, diet and drug industries all promoting health compromising products to consumers through national promotional strategies, you cannot be expected to compete for consumer attention on your own. You need and deserve help. By coming together and taking advantage of an initiative like the one described here, you become a force, a force that is an attractive partner to national non-profit and corporate sponsors trying to reach the same key demographic, those actively seeking to improve their health. This opens the door to co-sponsored national events, public relations exposure, increased credibility and greater cultural authority. You may not be able to outspend them but, with radical strategies and an aggressive agenda, you can certainly outthink them. Imagine proper care and maintenance of the spine being as important to the health care consumer as the care and maintenance of their teeth. Have you tried to make a same day dental appointment recently? Better yet, don't imagine. Make it a reality. Herb Newborg is Vice President o/Chiro-praclic America LLC (www.chirouxa.com) and has spcnl the past 18 months researching and developing strategies to increase chiropractic awareness and utilization. He can he reached at 215-310-1735 or hn(a>chirousa.coni.\ How likely is it that the internet user will find accurate, positive information on chiropractic that will encourage them to see a chiropractor?
