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How the internet is changing health care

BMJ 2008; 337 doi: (Published 22 July 2008) Cite this as: BMJ 2008;337:a883
  1. Michael Cross, freelance journalist
  1. 1London
  1. michaelcross{at}

    A new website allowing patients to rate doctors has attracted much attention. But, as Michael Cross reports, the internet offers many more possibilities for empowering patients

    Medical practitioners have long been public figures. However, the worldwide web is subjecting doctors to a level of popular scrutiny once reserved for politicians and entertainers. From last week, anyone with access to the internet has been able to read anonymous patients’ reviews of individual doctors in the United Kingdom, searchable by name, location, and specialty.

    iWantGreatCare is part of a healthcare information phenomenon: the compilation and sharing of facts and opinions by patients equipped with new techniques for sharing multimedia data. Although sometimes dismissed as another internet craze,1 so called web 2.0 is attracting interest as the catalyst for a consumer led revolution in health care. The London think tank Demos says the “democratisation of information” through technologies such as user created “wiki” encyclopaedias and online social networks will fundamentally change the relationship between patients and healthcare practitioners.2

    What is web 2.0?

    Web 2.0 covers a range of activities in which web users create online material for publication to their peers. They can take the form of

    • Wikis (collaboratively created knowledge bases)

    • Social network communities such as MySpace

    • Collections of shared video and audio files (often stolen) or

    • Mash-ups presenting data drawn from many sources.

    The defining feature is that information flows, usually for free, between peers rather than down a traditional chain of author, publisher, and reader.3

    Not everyone is comfortable with the idea. The founder of, Neil Bacon, has already received a letter from libel lawyers acting for 37 doctors, warning of possible action. Dr Bacon dismisses the threat as representing the fears of only a “tiny minority of doctors.” In the first week of operation, he says, 96% of …

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