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

THE MEDICAL MATRIX: WHICH DOOR IS OUT?

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

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