Internet disruptions in the doctor–patient relationship

Abstract

The ubiquitous access by patients to online information about health issues is disrupting the traditional doctor–patient relationship in fundamental ways. The knowledge imbalance has shifted and the last nails are being hammered into the coffin of medical paternalism. Ready access to Dr Google has many positive aspects but the risk of undiscerning acceptance by patients of unscientific, out-of-date or biased information for their decision-making remains. In turn this may feed into the content of the legal duty of care for doctors and contribute to a need for them to inquire sensitively into the sources of information that may be generating surprising or apparently illogical patient treatment choices. In addition, patients, those related to patients, and others have the potential to publish on the Internet incorrect and harmful information about doctors. A number of influential decisions by courts have now established the legitimacy of medical practitioners taking legal proceedings for defamation and injunctive relief to stop vituperative and vindictive online publications that are harming them personally, reputationally and commercially. Furthermore, disciplinary accountability has been imposed on doctors for intemperate, disrespectful online postings. All of these factors are contributing to a disruptive recalibration of the dynamics between doctors and their patients.