Uncertainty prompts me to write that as a doctor, I do not know what to tell Pennsylvania patients when they ask me if hydraulic fracturing - fracking - in their neighborhood or region might affect their health.

I've seen anecdotal stories in the media. I've read as much as I could find about how the hydraulic fracturing process works. But I'm still uncertain because we lack data and research on the matter.My colleagues in the Marcellus Shale regions tell me that they are getting questions from patients every day, such as, "I've had well water for many years - should I have it tested now that there's a gas well nearby?" and "I've had this rash off and on for a while; could it be related to the gas well they just finished a mile or so up my road?" or "A gas well was just finished near our house; my children play nearby and even though they're not sick right now, how will I know if they get sick from iteven years from now?"We have no definitive answers to these questions because we lack data.These physicians are also concerned about other rapid changes within their rural communities that could potentially impact health, such as increases in truck traffic, industrial accidents, and overloads of local hospitals and health facilities.The basic question for physicians is not which side to pick for or against fracking, but rather to ask, are we doing a good enough job being watchdogs for public health in these regions?As physicians, we are also scientists. We highly value evidence-based research as the basic tool we need to better assess and treat our patients, and to be better advocates for protecting the community's health.Regardless of the environmental controversy, and regardless of how slowly or how quickly this new industry develops, we recognize that there is already a need to conduct epidemiological studies and to educate ourselves and the public about the best ways to keep our communities healthy.Nothing frustrates me more than having my medical expertise hand-cuffed by lack of research.I support the elected leaders in Harrisburg seeking money to collect health data and conduct unbiased, comprehensive studies of the health of communities within our Marcellus Shale regions, and to help educate patients about their health.Such studies may reveal potential impacts on the health of Pennsylvania's citizens, they may show that other impacts should be of more concern, or provide another perspective. Without such unbiased research, no one can honestly tell you - today or tomorrow if fracking has any impact on the health of our communities.The energy needs of our country will always require a delicate balance between the environment and extraction of these resources. Protecting public health is my role as a physician. Marcellus Shale can be a saving grace in terms of reviving rural Pennsylvania economies and meeting the energy needs of our country. But we must monitor and identify potential risks to public health and develop ways to minimize that risk.Marilyn J. Heine, MDPresidentPennsylvania Medical Society