A recent New England Journal of Medicine article concludes that “Although the Internet is reshaping the content of the conversation between doctor and patient, we believe the core relationship should not change.”  They couldn’t be more wrong.  Not only should the relationship change, but it already has.

Untangling the Web — Patients, Doctors, and the Internet by Pamela Hartzband, M.D., and Jerome Groopman, M.D., provides a quick summary of the various ways patients use the Internet for healthcare.  Examples include gaining access to the same resources that physicians use for health information, sharing health experiences with other consumers and accessing health records online through secure portals.

The article downplays the role of online information as inaccurate, too complex for patients to understand, and sometimes harmful.  But that genie is out of the bottle.  Rather than fueling the fire of physician resistance to these tools, let’s look at constructive tools for addressing the challenges that remain.

Let’s begin with the notion that the relationship between physicians and patients could possibly be the same in an internet-connected world than in a pre-connected world.

The classic relationship between patients and doctors is based on a high degree of information asymmetry.  Physicians have the knowledge.  This creates a power imbalance in the relationship.  It causes many decisions to be made on the basis of the physicians’ interests rather than the patients’ preferences.

While not perfect, the Internet closes the information gap between physicians and their patients.  According to a 2007 study by Harris Interactive, Internet users are just as likely to view the Internet as their primary source of health information as they are to view their physician in that light.  Another 2007 Harris interactive poll noted that 25% of adults, between 18 and 34 years-old, use the Internet exclusively for health information because they are too embarrassed to consult a physician.

Can we really say the relationship hasn’t changed?

So, given this reality, what should physicians do?

• Know what’s available. Know what online resources are available for the conditions you commonly treat.  You don’t need to actively contribute to the discussion, but you should know what exists and develop informed opinions.
• Be proactive.  Point patients to resources you trust. Hospital websites and general health sites such as WebMD are good starting points, but patients with chronic diseases need greater depth and updated information over time.  Condition-focused sites such as those run by many national chronic disease associations can be good places to begin.
• Get involved in portal initiatives and advocate for your patients. The article suggests that a patient’s access to their own health information can cause unnecessary anxiety.  Be sure that such results are conveyed with supporting information to help patients interpret and understand.
• Monitor your personal brand. Web 2.0 provides you with a great opportunity – you can listen in as others talk about you.  Pay attention to what your patients are saying about you, your practice and the hospitals you work with.  Consumers are visiting these sites before they decide to be your patient.

The patient-physician relationship has changed and physicians need to understand what that means for them.  Although basic information is now a commodity, physicians still play the critical role of interpreting, advising and guiding patients.  This should be an exciting change for most medical professionals and one which I hope they embrace.