Big companies still believe the key to success on the Web is to make it all about shopping and fun. No wonder they’re losing money. It turns out a major reason people go online is pain. According to surveys, millions are using the Web to research their infirmities and diseases. Bread and circuses still abound, but they’re competing for clicks with an even older human yearning for cures.

Though the dot-com crash squelched a lot of the hype about the Web, its emergence as a health care oracle is one quiet way it truly has altered modern life. The change is obvious in the exam room, where patients now show up better informed about what’s ailing them. They’re also more likely to know what their treatment options are, and what they really cost—whether in dollars or potential suffering. Today, only veterinarians know the luxury of working with patients who can’t talk back.

Many sites have opened to meet the demand for health information. The Mayo Clinic site (www.MayoClinic.com) is one example. Gary Schwitzer, the site’s former

editor-in-chief and now an assistant professor at the University of Minnesota, continues to work with the Mayo on designing online “health decision guides,” including one for women with early-stage breast cancer. As Schwitzer notes, people getting bad news about their health are often too shocked in the doctor’s office to understand the choices they suddenly face. Such online guides can lead you through the various treatment options in a rational way.

But big virtual clinics are not the only portals of choice. A Pew survey on Internet use found that most “health seekers” begin at a search engine, instantly assembling a virtual medical symposium tailored to their private afflictions. Users then browse through the myriad therapies touted behind the links. Mainstream medical doctrine sits side by side with alternative opinions and first-person testimonials.