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The Internet: Altering the Physician-Patient Relationship

By: 
Renee Despres
Friday, November 11, 2011 - 14:45

Considering that I’m senior editor here at ehealthMD.com, I read with great interest a recent news release titled “Patients Shouldn’t Navigate the Internet without Physician Guide.” Oh my… does that mean you need to have a physician sitting at your shoulder while you surf? I wonder what the fees would be?

My interest piqued and my blood pressure a little elevated by that headline, I headed over to the article at the New England Journal of Medicine website. As it turns out, the authors — two MDs (endocrinologists, to be more precise) — are not proposing that you hire a physician to sit by your side as you read health content on the internet. They’re simply out to explore the changes in the physician-patient relationship that the internet has brought — although they do seem a little uncomfortable with it. Here’s their opening paragraph:

Medicine has built on a long history of innovation, from the stethoscope and roentgenogram to magnetic resonance imaging and robotics. Doctors have embraced each new technology to advance patient care. But nothing has changed clinical practice more fundamentally than one recent innovation: the Internet. Its profound effects derive from the fact that while previous technologies have been fully under doctors’ control, the Internet is equally in the hands of patients. Such access is redefining the roles of physician and patient.

Nicely said. The internet has led to a fundamental change in doctor-patient relationships. And it can’t be all bad that the change is one that leads to a bit more equilibrium between doctors and patients. But the authors don’t seem to be quite as excited about that balance. They authors go on to point out that there’s a lot of conflicting advice on the internet — ranging from outright falsehoods about “novel therapies” to “chat rooms and blogs filled with testimonials.” They’re clearly uncomfortable with some of the changes (for instance, patients who “feel free” to e-mail their doctors or other doctors).

But conflicting advice may not always be false advice. Even experienced physicians can disagree. Likewise, articles published in peer-reviewed journals — which are now widely accessible — can be a quagmire of contradictions. Even if you’re perusing the highest-quality studies, performed using strict experimental methods (double-blind control groups and researchers, for example), the studies may not agree. One study may suggest that Vitamin E supplements are effective for reducing arterial plaques; another may suggest that there’s no effect — or worse, that high doses of Vitamin E are associated with increased mortality.

Could it be that the authors of the NEJM article are simply a little uncomfortable that the internet exposes just how much is not known in medicine?

Interestingly, public health folks have an entirely different view of the internet. To them, it’s a tool to increase health literacy, which is notably poor, both in the United States and worldwide. Sites like Medline Plus serve as examples of ways public health practitioners are using the internet to improve health literacy. Such sites provide tremendous resources for everyone — patients, physicians, and those in between.

That’s what we do here at ehealthMD.com: provide honest, reliable health information that is accessible, clear, and useful to everyone. We believe that when people are well informed about their medical conditions, they can work with their physicians to find the best solutions for them. Are there drawbacks to the use of the internet? You bet. Should the internet substitute for a visit to a physician? No way. Is it a bad thing that the internet has profoundly altered the physician-patient relationships? Absolutely not. It’s about time that communication between physicians and patients became a two-way street. It is a struggle — for physicians and patients, primary care physicians and specialists — to figure out how to use this new medium. But with reliable, credible health information available online, patients are better armed to become involved in their own health and health care.