The relationship has changed over time – from patients passively receiving treatment based on the doctor’s judgement to actively participating in the decision-making process. 

 

 

The connection between physicians and their patients is evolving fast, driven by many factors. Not so long ago, a doctor used his / her skills to decide the course of action while the patient silently complied. But in the recent years, the approach has been of mutual participation and patient-centric with greater patient control and reduced doctor dominance. Per a study published in the The New England Journal of Medicine, the decision making authority has shifted from the Doctor to the patient.

 

What Caused the Shift? 

This change in the relationship can be attributed to technology. Online medical portals have given patients access to medical information and the ‘internet informed’ patients are surfing the internet to obtain health information.  
According to a review published on NCBI, the majority of, these searches are for specific medical conditions which are carried out: 

•    Before Meeting the Doctor – to help the seeker decide whether they can manage the ailment themselves or whether they need professional help.
•    After Consulting the Doctor - for reassurance or when not satisfied with the information provided by the physician. 

 

The Boon of Online Health Information

 

As of January 2017, India is the second largest online market with 462 million internet users, and increasing numbers of patients are accessing online health information. An analysis conducted by Eysenbach G, Kohler C estimated that globally a minimum of 6.75 million health-related online searches is performed every day. This newfound source has given many patients the impression that they can manage their ailments on their own, with doctors serving primarily as consultants. 
On a positive side, an online medical search can provide support and reassurance, and impart a sense of empowerment in the patients.  It also helps reach out to online health communities which can provide social support to patients going through similar health concerns. 

The enriched knowledge from ‘Googling’ the symptoms can lead many patients to self-diagnose and self-treat.  And if done responsibly, the benefits are: 

•    Encourages an active role of the patient in his or her health care
•    Aids in speedy and economical access to treatment
•    Enables better use of doctors’ skills 
•    Reduce or optimise the burden on health care infrastructure

Per a study titled Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication, the advantages of using the online media channels include: 

•    Increased interactions with others
•    More available, shared, and tailored information
•    Increased accessibility and widening access to health information
•    Peer/social/emotional support
•    Public health surveillance
•    Potential to influence health policy

It Could Be A Bane Too

But the wealth of information accessible has proved to be harmful too. Health related search online can induce unnecessary anxiety (cyberchondria)  in patients when they employ it as a diagnostic procedure. A misdiagnosis leads to non-responsible self-medication causing the improper and irrational use of medicines.

 

Potential risks include: 

•    Delay in seeking medical advice
•    Dangerous drug interactions
•    Rare but severe adverse reactions
•    Incorrect choice of therapy, dosage and manner of administration
•    Masking of a severe disease
•    Risk of addiction and abuse

The study also highlights the limitations of social media for health, and they are: 

•    Quality Concerns
•    Lack of Reliability
•    Confidentiality
•    Privacy

 

The Doctors’ Response 

Doctors are now more often consulting patients who have formed their amateur medical opinion based on online health search. They are responding to this scenario in one or more of these ways: 

1. Doctor- centred relationship: Asserting their 'expert opinion'. 
2. Patient-centred relationship: Acknowledge and collaborate with patients to obtain and analyse the information. 
3. Internet prescription: Guide patients to reliable and accurate online health portals.

 

Per ENT specialist Leena Patel, when a patient sees her already with an armload of online information, she tries to be patient. "I hear them out and then give them my expert opinion and the course of action. After all, my job is to treat them regardless of what they already think they know", she added. 

The Evolving Doctor-Patient Relationship

Online information is empowering patients. But it cannot substitute professional expertise. Today, shared decision making is helping find a healthier balance of power between patients and doctors. The doctors have the know-how and authority over matters of medical science, while the patients hold power over questions of values or preferences.