James Heilman is on a mission to fix Wikipedia. He believes skewed and half-baked information circulating online menaces our health-care system and the well-being of its patients. He doesn’t want people to get sick. Nor does he want people to make themselves sick obsessing over possible symptoms. So he works slowly to correct Wikipedia’s medical articles, sentence by sentence, study by study, from anywhere-at home in his Cranbrook, B.C., apartment; in the emergency room where he works as a night-shift doctor; or at the airport waiting for a flight. Now 33, Heilman started five years ago when, during a slow night in the ER, he came across an error-riddled obesity article. Realizing he could edit the entry, he dived in, making hundreds of changes, from updating citations to changing unclear language and ambiguous vernacular. He went from there. Wikipedia’s open-source philosophy means others can undo his work. But he’s not alone: 655 Wikipedians monitor the obesity article for changes. Those volunteers aren’t all doctors, but many share Heilman’s ambition. “As health-care providers, we have a responsibility to make sure what our colleagues, patients and students read is accurate,” he says.
Wikipedia is the world’s single most-used online source for health queries, often appearing in the top five results in any Google search. The site’s medical content sees an estimated 15 million page views a month in Canada alone. Wikipedia has become a solid starting point to learn about ailments and disorders because the entries-some of which are written by knowledgeable patients living with the conditions-are assayed by a team of three dozen doctors volunteering to do what they can to regulate the constant surge of information coming from 80,000 hyperdedicated active users and new medical research being published every day. It’s slow work: the site hosts 28,000 medical articles. Since 2008, Heilman has edited 10,000 of those articles to varying degrees. But it takes him nearly two months, between work and other research, to bring one article up to snuff. He estimates he’ll be revising his slate of 80 topics for the next six to 10 years.
Compare that to WebMD, an advertiser-funded health-information website that the New York Times has called a “hypochondria time suck.” WebMD is loaded with articles on everything from weight-loss tips to symptom checklists, but its well-documented and lucrative ties to Big Pharma have caused concern among medical professionals who complain that the site-which attracts an estimated 125 million unique users a month from around the world-tends to promote hysteria and drug-peddling. In his 2010 investigation into the company, U.S. Republican senator Chuck Grassley pressed WebMD to explain why it was offering a depression-screening test paid for by drug company Eli Lilly that pointed users toward Lilly’s antidepressant Cymbalta.
Heilman-who has often sparred with pharmaceutical companies that are trying to change Wikipedia’s content to favour their products-says sites such as WebMD have been instrumental in helping drug companies establish some conditions as diseases. “Erectile dysfunction was more or less unheard of 20 years ago, before the advent of Viagra,” adds Heilman. But in order to promote Viagra, he explains, you need to promote a disease associated with it. “Call it erectile dysfunction, and you can get approval from the Food and Drug Administration,” he says. WebMD’s recommendations for erectile dysfunction? Minor lifestyle changes: lose weight, quit smoking and cut down on alcohol. But it also insists men may need further treatment including-surprise-medication. And to the left of the article? A banner ad for Cialis.
Heilman is a full-fledged advocate of online health-care information sharing, and spends dozens of hours a week reading up on new cases to help him hone his judgment calls in the ER. He admits online forums can be destructive-U.S. drug companies have been suspected of covertly setting up health sites and hiring “independent” health bloggers to praise their own meds-and that even harmless-looking sites such as Yahoo! Answers offer alarmist information. “The most important thing is to be skeptical and to speak to your doctor before you act on anything you read on a medical website-no matter how reliable it seems,” he says. Still, Heilman is happy the days of doctors as medical gatekeepers are over. “I think it’s excellent that patients are be-coming involved in their care,” he says. In the meantime, he’s going to do everything he can to ensure that when they start looking for answers, accurate information is what they find.