To the Editor,

I read with great interest the article “I found it on the internet” Preparing for the e-patient in Oman,1 
published in SQUMJ in August 2010. Briefly, this article reviews the e-patient, medical student and the 
relationship between them. I would like to share with you and the readers my views regarding the above 
article. In my opinion, an e-patient is easy to deal with as he/she listens, understands and does what his/
her doctor asks him/her to do properly. He/she is not difficult. This is because I find e-patients similar to 
university students. University students have high levels of knowledge and good communication skills and 
therefore cooperate well. Their unanswerable questions may be of great benefit as they may lead the teacher 
to undertake more research. In my opinion, the issue of preparing medical students for the e-patient in Oman 
is not a demanding one. In general, medical students, from SQU or the Oman Medical College, are well 
educated and have wide training experience. In addition, there is no specific data on the number of Omani 
patients seeking for health information via the Internet as Dr Masters only gave figures for general Internet 
use in Oman. On the other hand, non-university students, like non-e-patients, have less understanding and 
are less inclined to cooperate. 

I also think that e-patients should be faced with e-doctors. In addition to their existing knowledge, 
e-doctors can enhance and increase their medical knowledge using various and wide Internet resources. Thus 
they will strengthen their ability to answer many questions posed by either e-patients or regular patients. 
Thanks to the various number of medical websites, the e-doctor can now play an even more beneficial role 
in the consultation than the e-patient, in particular as regards the treatment plan. 

A far more pressing concern in Oman is the number of patients going abroad for treatment, even for 
appendicitis or tonsillitis. The number of patients that are treated abroad at Ministry of Health expenses in 
2009 was 4522 and the number is on rise. Governmental and non-governmental sponsorships for medical 
travel abroad are limited. It is important to note that the majority of Omani patients who go abroad for 
treatment therefore do so at their own expense. E-doctors can play a major role in reducing the number of 
these patients. If I can trust my doctor, then he can start treating me. Trust in treatment starts with a patient 
or e-patient, and then it goes to friends and family, then community and finally the whole country. Trust 
is an easy word to say, but it is very hard to achieve and takes a longer time to take root. Prospective and 
retrospective studies should be undertaken to highlight currently hidden information about e-patients and 
e-doctors in Oman.

Nasar Alwahaibi
Department of Pathology
College of Medicine & Health Sciences
Sultan Qaboos University, Muscat, Oman 
E-mail:  nasarsidab@yahoo.com

SQU Med J, February 2011, Vol. 11, Iss. 1, pp. 129-131, Epub. 12th Feb 11
Submitted: 10th Nov 2010

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Re: I found it on the Internet”
Preparing for the e-patient in Oman

Nasar Alwahaibi

LETTER TO EDITOR



Re: I found it on the Internet” 
Preparing for the e-patient in Oman

130 | SQU Medical Journal, February 2011, Volume 11, Issue 1

References
1. Masters K, Ng’ambi D, Todd G. “I found it on the internet”: Preparing for the e-patient in Oman.  SQU Med J 2010; 

10:169–79.

2. Ministry of Health, Oman. Annual Health Report. Morbidity and Mortality. Muscat: Ministry of Health, 2009. Ch 9, 
pp. 9–92. 

Authors’ Response
Dr. Alwahaibi’s close reading of our article, and the resultant comments, are appreciated. He raises several 
points, and we would like to respond to each of them.

First, Dr. Alwahaibi’s experience with e-patients is encouraging, and reflects a similar pattern that has 
been found elsewhere. In my own research,1 I found some doctors relishing these consultations, finding them 
stimulating, and one even likened it to an enjoyable objective structured clinical examination (OSCE). To get 
patients to this stage, however, frequently requires patience and guidance from the doctor. It is this patience 
and guidance that our article wishes to encourage.  

In addition, unfortunately, my own and other research has found that e-patients are not always like this. 
For example, some patients who would normally be confrontational have used the information found on the 
Internet to raise the confrontation to a new level, in an attempt to intimidate the doctor. Patients can also 
become confused or misled by the information they find on the Internet if their searches are not guided. And 
then, there are the so-called “cyberchondriacs.” Our article is aimed at ensuring that medical students are 
alerted to these issues, and can manage the resultant situations competently.

Second, we agree wholeheartedly that e-patients should be faced with e-doctors. Indeed, the Medical 
Informatics courses taught to Sultan Qaboos University students in both Phase I and II are aimed at equipping 
the students with these skills. I currently teach on those courses, and I will gladly share the curriculum 
outline with Dr. Alwahaibi (or any other reader) on request.

Third, as Dr. Alwahaibi points out, our article does not provide figures on the number of Omani patients 
seeking health information on the Internet. Unfortunately, no research has yet been published on that topic. 
Indeed, part of the motivation for the paper was to provide the impetus for a research project to do just that. 
Until we have such data, however, there is no reason to believe that the proportion of e-patients (compared 
to Internet users) is significantly different in Oman from other countries, so proportions of total Internet 
users can be used as a guide.

Moreover, in our article, we made the prediction that the number of Omani Internet users would follow 
Roger’s diffusion curve,2 and was set to increase at an accelerated pace in the very near future. The latest 
figures3 indicate that this acceleration has occurred. Our article used 2009 figures, which estimated the 
number of Omani Internet users at a little less than 500,000. By 2010, this figure had increased to more 
than 1.2 million.3 In the light of this dramatic increase, the need to accommodate the e-patient is possibly of 
greater urgency than was the case when the article was written.

Finally, I am not qualified to comment on the reasons for Omani patients seeking medical treatment 
elsewhere, but I certainly agree with Dr. Alwahaibi that a student who has been well trained to deal with the 
information will undoubtedly inspire confidence in any e-patient. Further, I agree that studies of e-patients 
and e-doctors should be undertaken in Oman; if Dr. Alwahaibi would like to collaborate on such a project, I 
would welcome further correspondence on the subject.

Ken Masters
Medical Education Unit 
Faculty of Medicine & Health Sciences 
Sultan Qaboos University 

Email: kmasters@ithealthed.com



Nasar Alwahaibi

Letter to Editor | 131

References
1. Masters K. The Diffusion of the Internet amongst South African Primary Care Doctors: An Activity Systems View.

Unpublished PhD Thesis. University of Cape Town, South Africa, 2009.

2. Rogers E. Diffusion of Innovations. 5th Ed. New York: Free Press, 2003.

3. Internet World Stats. Internet Usage in the Middle East. From: http://www.internetworldstats.com/stats5.htm. 
Accessed: January 2011.