On how the Internet changed medicine in the 21st century…


Do you remember that really irritating patient that came to ED at 3AM with a five-month history of neck pain, saying that the web told her that she might have a subarachnoid bleed? You probably thought – who the hell are you to self-diagnose – I am the doctor, not you!

The rapid propagation of the web means that the public is better informed about health issues than ever before. Some patients are now self-anointed experts and have made the questioning of decisions and diagnosis an art form.

Self-diagnosis is as easy as a keyboard click, with easily accessible search engines and online medical dictionaries. You can now bypass the ED or your GP; you can even self prescribe medication from dodgy websites offering anything from protein shakes to sexual performance enhancers.

Even if a website is robust and the information from a professional medical database, how reliable is it? Can laypeople understand the jargon and reach sensible conclusions? Or do they only believe what they want to believe when they find a site that tells them what they want to read?

Patients also seek information about their doctors online. They know who misdiagnosed a child with flu but who later died from meningococcal septicaemia last year, as it was on the web.

Professionals have also benefited from this digital revolution. We can now easily access the latest research and evidence and share it with our colleagues. It lets us learn remotely, especially useful for people working in remote areas or in developing countries.

How do we balance the current philosophy of empowering patients to make their own decisions without returning to an archaic hierarchical one-way communication and paternalistic style when they come to us spouting nonsensical rubbish?

How do we ensure Data Protection and patient confidentiality?

How do we respond to patients who try to befriend us on Facebook or Twitter?

Will the web bring more problems than solutions? Are we mature enough to use it safely?

Will too much information make us all sick?

Janos P Baombe/Sivanthi Sivanadarajah

  • Max

    This small essay/blog post reads like it belongs in 2006.  Between 2007 and today there have been at least 200 articles and position statements about Facebook and Medicine alone ….

    I think a more current and comprehensive post would be one that mentions how mobile tech is revolutionizing research in the developing world or how surgeons in Michigan use a live Facebook feed to get colleagues involved across the continent. Or how some EMS systems use an online control system for triaging AMI and Stroke patients. In other areas we have failed miserably to utilize the internet in a cost effective manner…. I.e. the lack of large scale electronic medical national level records (that are useful to clinicians) in North America (probably except for Alberta, Canada). 

    The ethics of the online docotor-patient relationship will have to adapt to our newly found state…. We can’t go back so we must go forward. I implore the editors of this blog to consider that we do not to neglect the major advances we derived from the internet (and now Web 2.0) while mentioning minor ethical dilemmas –  which are being worked out as speak in the most current social media literature.