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Scalpel: Technology @ the Edge of Medicine

To Epocrates or Not to Epocrates?

Published May 14, 2010 9:30 AM by Joseph Weber
I'm confused. I've been using Epocrates Essentials for two years now, and I love the program. The ability to look up diseases, medications, lab tests, tables and more has made this an invaluable tool in the clinical setting.

Then, a few months ago, I downloaded Medscape from WebMD on my iPhone. One striking difference between the two programs is that Epocrates costs $159/year, while Medscape is FREE! Of course, price isn't everything, and I'm certainly willing to pay if the tool provides significant additional utility.

I kept Epocrates around for a few extra months beyond my subscription end date by using their EssentialPoints feature. This is a feature typically sponsored by pharmaceutical companies, who will provide you with a free one-month extension to your subscription if you complete their "activity" on Epocrates.

This is a nice feature and, frankly, the "activities" are well done and worth your time in exchange for a free additional month. I've now hit the "update" button several times on Epocrates hoping for more free months, but it looks like I've reached the end of my free ride. It's time to pull out the credit card or say goodbye to one of my favorite tools.

I originally started using Medscape on my iPhone for CME activities. As a dad, one of my daily duties is to pick up my daughter from school. While I'm sitting in my car waiting for the rush of screaming kids to emerge from the school, I sit quietly and do a CME activity. I have been very impressed with the activities. They are quick, easy and informative.

While trolling around Medscape looking at CME activities, I started to notice the many other features and realized that the program has many more uses than just providing CMEs. It's truly an amazing piece of software for FREE! It contains sections for drugs, diseases, clinical procedures, a drug interaction checker, physician directory, medical references, and the list goes on.

I compared several common conditions between the two applications, and I'm pretty comfortable that the key information I need is in Medscape. Because asthma is a common condition, I did a comparison between the two software programs. Frankly, for the most common conditions, I think I'm fine just using Medscape. As far as drug references go, here is a comparison for Xopenex:

      

Epocrates on the left, Medscape on the right.

There are some obvious differences, too. For example, Epocrates has much more granularity in some categories. For example:

       

Epocrates on the left, Medscape on the right. 

Now, here is the difficult part: many of the features I use on a daily basis are in Medscape. I'm just not sure if, on a frequent basis, I need the additional granularity of Epocrates or if it's worth the money for the subscription. As of today, my subscription for Epocrates has lapsed. I know I can always renew if I need the information. For now, I think I'm going to stick with Medscape.

I'm curious about your thoughts. Did I make the right decision?

Happy Computing!

Cheers,

Joe

14 comments

Hi Kathy,

Great to hear from you!  Glad the job is going well. I still keep in touch with many of our Gannon colleagues and most sound like they are doing very well.  Hope to see you at a conference or something.

Cheers!

Joe

Joe Weber, Emergency Medicine - Physician Assistant, University Hospitals Case Med Center May 27, 2010 8:42 AM
Cleveland OH

Joe!  You old dog!  Great to read this blog and then see it was you!  Hope your job is going well.  I love mine and couldn't be happier (unless they paid me more...).

Kathy Wrona, hospitalist - PA, GBMC May 26, 2010 7:03 PM
Baltimore MD

Hi Robert,

Great point.  I'll check it out.

Cheers,

Joe

Joe Weber, Emergency Medicine - Physician Assistant, University Hospitals Case Med Center May 17, 2010 3:41 PM
Cleveland OH

Everyone should check out Skyscape which offers both free and paid for medical resources from gold-standard medical publishers.

Robert May 17, 2010 2:42 PM

As a neurologist I find the ePocrates a better deal even if I have to pay (you can deduct it as a business expense). I find I can better look up drugs and conditions faster and with better precision especially possible complications. Also the ePocrates web site which I can use when I do not have my iPhone with me is another bonus.

One thing not mentioned is that I find the help people at ePocrates much much better and responsive. When I contact them they respond in hours, usually with the right answer. Medscape takes days, if at all.

I also agree that you should compare the free ePocrates to the free Medscape. But then, you get what you pay for.

Todd, Neurology - Physician, hospital/Clinic May 17, 2010 10:02 AM
Des Moines IA

Hi Everyone,

Great comments and you all make excellent points.  Hence, my struggle on deciding to keep or let go Epocrates...

I do like the formulary information in Epocrates and it also has more precise costs.  MedScape does provide cost information but it's a range.  For example $60-100 for Lipitor in Medscape.  The same med in Epocrates lists the price as $95.99 (this is the 10mg dose).  

As Robert points out, it certainly may make sense to have both the free version of Epocrates and MedScape loaded as reference tools.  

The drug component is an interesting point of comparison, but just curious about others thoughts on the other components of the full product suite in Epocrates compared with MedScape...including drug interaction, differential, workup, etc contained in the products.

This weekend I used MedScape for a quick refresher for a pt I had in A. Flutter.  It definitely did an excellent job at providing all the background information along with pathophys, epidemiology, ECG rhythm strip example, medications, medication references to journal articles, etc.  At the grand price of FREE, that's a pretty good deal.

So far, I'm still with Joel and thinking I will not renew my subscription either.

Great comments and I thank everyone for taking the time to post comments!  Keep'em coming!

Cheers!

Joe

Joe Weber, Emergency Medicine - Physician Assistant, University Hospitals Case Med Center May 16, 2010 6:41 PM
Cleveland OH

For drugs, Epocrates is better. Adverse effects easier to read in list format and better information on drug costs too.

For CME, Medscape is better.

No reason not to have both (free) versions.

Robert May 16, 2010 11:04 AM
DE

Epocrates has a free version. A fair comparison would involve the free versions of both products.

Joe Anderson May 16, 2010 4:52 AM

My original comments did not appear in it's entirety.  I have been an advocate for epocrates for many years.  I have used epocrates since it's inception.  About four months ago I download to my IPhone the Medscape program.  First, it should be noted I have been disappointed ion Epocrates ever increasing price.  Initially, it was free in various ways.  Now is is overpriced; especially with EMRs including most information needed for prescribing.  I find the Medscape program is somewhat better than epocrates and it is FREE.  My subscription is up in December and I plan on staying with Medscape until they decide to start charging.

Joel Peveler, , Physician Assistant Owensboro Medical Health System May 14, 2010 8:30 PM
Owensboro KY

I too have used Epocrates for many many years

Joel Peveler, , Physician Assistant Owensboro Medical Health System May 14, 2010 8:21 PM
Owensboro KY

The screens you chose to compare make a difference themselves. Knowing the cost these days is HUGE for patients, and Epocrates does an awesome job of showing multiple formularies. Patient compliance often depends on affordability of the treatment - this is a patient care issue. I find it incredibly helpful.

James, PM&R - Physician Assistant May 14, 2010 4:04 PM
Traverse City MI

I have downloaded Medscape twice and tried it. Each time, I found it wanting. I use my Epocrates multiple times in a day, for medication doses and interactions. I use many specialty meds and Epocrates does a better job for me. I have deleted Medscape twice after trying it - no specific complaints, but having used Epocrates for years, and trusting it fully, and trying Medscape, I just have a level of discomfort with anything other than Epocrates, which has been the gold standard and the leader in the field for many years. I find the alerts and communications relevant, even in my specialty. I feel it is well priced. Have you bought a book lately? Updates are incredibly important. With Epocrates they are always right on.

James, PM&R - Physician Assistant May 14, 2010 4:00 PM
Traverse City MI

Hi Scott,  

Thanks for your feedback. It will be interesting to see if/how this will impact Epocrates in the long-term as people start to evaluate the value proposition for the $'s.  

Thanks again for your input!

Cheers,

Joe

Joe Weber, Emergency Medicine - Physician Assistant, University Hospitals Case Med Center May 14, 2010 1:24 PM
Cleveland OH

I have been using Epocrates on my Windows Mobile phone for the past 4 years now.  Recently though my phone started acting up and I ended up deleting Epocrates to open up some space.  When this happened I realized that I could look up drugs and Dx for free on Epocrates Online.  I have yet to download Epocrates to my smartphone again because I am in an office on EMR and I have continual access to a computer.  The only thing I really miss is the med calculator, and looking up ICD-9 codes, which I rarely have use for.  So, as of right now I am going to let my subscription lapse.  If only there were a Medscape for Windows Mobile app, I'd try that.  

Scott May 14, 2010 11:51 AM
Jacksonville FL

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