Access to health information on the Internet offers patients greater choice over treatment and autonomy in decision making. While doctors welcome empowered and better-informed patients, Internet-informed patients’ desire for greater choice and autonomy in health decision making may create friction between doctors and patients during consultations. Doctors are not always comfortable to accommodate patients’ choice due to uncertainty surrounding treatment options patients have found on the Internet.
In a study about an online health community (see Bernardi and Wu, 2022), we find that patients exercise a great deal of agency in evaluating and choosing treatment options recommended by the online community and managing their relationship with their doctor. Patients evaluated both the online community’s advice and the doctor’s advice from a medical standpoint. If from a medical standpoint, the doctor’s advice made sense, then patients were less reliant on the online community’s advice, neutralising any scepticism against the doctor’s advice put forward by the online community. However, if from a medical standpoint, patients could not find any logic in the clinical protocols guiding their doctor’s advice, they were more likely to trust the online community’s advice.
Our study also illuminates how patients manage the tension between their right to choose and their doctor’s advice. We find that the patient-doctor relationship is more vulnerable when patients perceive that their doctor or nurse are dismissive of their treatment choice or experience. When patients perceive that their healthcare professionals are not supportive of their choice, they adopt passive resistance by ignoring their clinical advice. Patients are thus empowered to follow the online community’s advice without spoiling the doctor-patient relationship. Finally, patients can be more pro-active in benefitting from the online community’s advice thanks to the support from their healthcare professionals. Patients can also draw boundaries between their doctor’s and the online community’s jurisdiction. Recognising the limitations of both their doctor’s advice and the online community’s advice, patients are capable of benefitting from both types of advice and maintain the doctor-patient relationship.
To conclude, our study finds that Internet-informed patients exercise a great deal of agency in managing the tension between clinical advice and patient consumerism or expertise fuelled by the Internet. We thus provide a more nuanced picture of the impact of online health communities and the Internet on the patient-doctor relationship.