Effect of the internet on the doctor-patient relationship: A review of the literature

Background: Despite an increase in the number of patients who use the Internet for health information, little is known about the effects of that searching on the doctor-patient relationship. Objective: To review the effects of patients' online searching on various aspects of their interactions with their doctor. Methods: We searched MEDLINE to find articles in the English language that contained pertinent data about patient Internet use and its effect on the doctor-patient relationship. After examining 697 articles that matched our search criteria, three investigators reviewed 71 candidate articles, of which thirty-three were selected for this review. The data extracted from these articles were grouped into four common themes: the Internet as a source of medical information; the use of Internet-acquired information during the clinic visit; the perception of health information on the Internet; and the impact of the Internet on the doctor-patient relationship. Results: The Internet has not replaced physicians as the primary source of medical or health information for patients. Patients do, however, trust the Internet as an additional information source and would like their physicians to recommend specific websites. Although some patients brought Internet-acquired information to their clinic visit, this is not a frequent occurrence. Patients report that the Internet decreases anxiety, improves understanding and communication, and has a positive overall effect on the doctor-patient relationship. Doctors generally agree with patients' responses, but are more likely to cite concerns about the accuracy of Internet information and how it may influence trust in the relationship. However, for the majority of patients and doctors, the Internet still has little effect on their relationship. Conclusions: The Internet appears to have a generally positive impact on the doctor-patient interaction and relationship, yet negative effects are also reported. Future research should include observational and experimental methods, to supplement existing studies that have largely relied upon survey methods.