“We are experiencing a healthcare reformation,” writes Joanne Shaw this week (doi:10.1136/bmj.b1080). Like the Catholic church in 16th century Europe, which threw away its Latin texts interpretable only by the priesthood, medicine is being transformed. With varying degrees of enthusiasm, acceptance, and resignation, doctors are interacting with an increasingly web enabled laity.

Some of you may think the reformation is complete or at least has gone far enough. But anyone who has been or supported a patient in the past few years will know that medicine finds it hard to shake off its paternalistic tendencies. There is a long way to go before patients truly …