Patients, clinical practice, and the internet

It used to be so much simpler. Doctors were the experts and told patients what to do. Patients listened and occasionally took notice. Doctors were criticised as behaving as if they were God, and medicine was something that was done to people. All too often the doctor-patient relationship, in transactional terms, was parent to child—and it wasn’t healthy.

It was knowledge that caused the power differential. In the past, a profession could be defined by the body of knowledge that it held. If you were not a member of a profession, it was extraordinarily difficult to obtain this knowledge. But now, anyone who has access to the internet has access to almost all the knowledge in the world, a development that has fundamentally changed the relationships between professions and the lay public. Indeed, the arrival of information technology can be seen as having similarities to the translation of the Bible from Latin. When the Bible was only available in the Latin language, the clergy controlled all access to this knowledge. Translation freed up this access, changing forever the role and position of the clergy.1

A similar seismic shift has affected medical congregations. Doctors no longer control the knowledge. While there are inevitably clinicians who find this change of role to be deeply uncomfortable, resisting this development is as futile as King Canute resisting the tide. And, like the tide, it can be used to …