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Google and the dot-health bubble

Doctors seek a solution to combat online pseudoscience


 

Google screen grab

It’s flu season. You want to learn more about the annual flu shot. Your first stop? Dr. Google. Over 78 million results pop up, all potential sources about the flu shot. Wikipedia, Purdue Pharma, WebMD: Who to trust?

A group of researchers, health associations, and consumer advocates think Googlers need help. We need a safe “top-level domain name” (the part of the web address to the right of the dot) that would separate evidence-based sites from pseudoscience trash.

Just as .gov suggests a governmental page, this group want to see .health on sites that have been vetted by a body, such as the World Health Organization, which would bestow the suffix only to those that have met some minimum quality requirements, limiting the fraud and abuse that are so common online. “A domain is associated with a site’s brand, origin content or quality,” explained Dr. Joan Helen Dzenowagis, who is responsible for the WHO’s eHealth governance unit. “The sites that fall under .health are likely to be considered the ultimate online source of information and advice on health.”

While the quiet quest for .health has been going on in the medical literature for more than a decade, according to a new commentary published in the Lancet, November could mark the loss of this battle against evil Dr. Google.

That’s because .health and other new medical top-level domains like .doctor and .hospital are poised for sale to private companies that have little or no health expertise, or plans for restrictions on who they sell related web addresses to. This is just the health angle on the Internet Corporation for Assigned Names and Numbers (or ICANN, the body that oversees the Internet naming system) project to expand the number of Internet domains. Soon, web addresses will be more varied and descriptive when the number of suffixes goes from a restricted 22 (.org, .com, etc.) to over 1,000 (.blog, .book, etc.). Imagine the possibilities: cure4cancer.health or worldsbest.doctor.

The researchers behind the Lancet article aren’t going to let this sale happen without a fight. They’re asking ICANN to reconsider and hand the .health domain over to an entity that would oversee its use in the public interest. As one of the authors, Amir Attaran of the University of Ottawa, told Science-ish, “I don’t want highly sensitive health information being vetted by private companies with zero expertise in health such as Donuts.com, and which are engaged in a mad rush for domains like .wtf at the same time as .health. None of that inspires confidence.”

Attaran has a point, but the campaign to secure .health also has its critics. Wendy Seltzer, a fellow with the Berkman Center for Internet and Society at Harvard Law School, said that imposing quality controls at the level of domain name registries isn’t quite right. “ICANN is not equipped to be a regulator,” she said. Plus, even when there are sanctions on who can have a domain name, they don’t necessarily work in practice. There are all sorts of non-accredited institutions that get .edu addresses, for example, and sifting good health sources from dubious ones could be even more difficult.

Susan Crawford, a professor at the Cardozo School of Law, said many people don’t find information through domain names any more: they use intermediaries like apps and social networks. “I wouldn’t put too much weight in, or worry about, the domain-name system. It’s becoming less important as a way for people to find info online than it has historically been.”

Still, almost 2,000 people paid nearly $200,000 to apply for ownership of one of these new domains. That must mean something. And the fight against Dr. Google is about a lot more than the internet naming system.

“The Internet has become a global asset for health,” said Dr. Dzenowagis. “It is critical to health security, health and medical education, connecting health research communities, and empowering people by giving them access to information, where ever they live.”

Through whatever means, we need more people to think about how to re-engineer the Internet for health. We need health professionals working alongside developers to figure out how to get high-quality information to people at the right time in a way that makes sense to them. Whether that’s with a special domain name, search-engine optimization, or an app doesn’t really matter. If this century’s health revolution is about getting people access to clean information, then the Internet is the most important delivery tool.

Science-ish is a joint project of Maclean’s, the Medical Post and the McMaster Health Forum. Julia Belluz is the senior editor at the Medical Post. She is currently on a Knight Science Journalism Fellowship at the Massachusetts Institute of Technology. Check back for periodic updates here and here, and reach her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto


 
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