What is the Physician’s Role in a Web-based World?

With all of the super accessible health information now available, consumers have turned into the  equivalent of first year medical students, armed with too much information but not enough objective experience. The ideal doctor patient relationship is a partnership centered around facts and good communication that is based on our experience. The internet has enabled us to communicate in ways which are more and more interesting and, ultimately, more efficient. Except the online doctor, the curator of all these personalized facts, is nowhere to be found.

I spent a few sessions with a psychiatrist my first year of med school because I was convinced I had MS. Well, 11 years later I’m symptom-free and here to tell you all about how I beat that crippling disease called Medical Student Syndrome. But as health professionals all know, it’s the combination of facts, experience, and reason that enables us to do our jobs well.

Fortunately for our ability to earn a living, internet health information is just facts. So our jobs are still needed because, for the foreseeable future, we still offer experience and reason.

All jobs consist of executing the steps within a larger project. Most people have five or six projects at any one time that keep them busy for 40 hours a week. Web apps like Basecamp and Action Method were created to help people get these steps done. They help people organize with a team of people, delegate responsibility to any one of their teammates, and keep track of the project’s progress. They’re absolutely brilliant and a lifesaver for the modern workplace.

Doctors have about 2000 patient projects. And we get, on average, one hour with each patient per year to serve as their project leader, delegating the other 8,765 hours to our patient who manages their health on their own, disconnected from us and unable to receive personalized information or ask questions except during the occasional, all-too-short office visit.

Both Basecamp and Action Method were designed to share information and facilitate goal-oriented, efficient, online communication between teammates who aren’t working in the same geographic area. Awesome! Wouldn’t that be nice to have with our patients?

Ha, in an ideal world. We only get paid for office visits and procedures. We surely don’t get paid for communication and definitely not for prescribing links personalized to each patient. And there isn’t a single profession in the world that works for free.

The reality is this:

Percentage of people age 65 and over online today = 41%

Percentage of docs and hospitals who use computers = 9%

Percentage of people with home computers in 1985 = 15%

Even the elderly are more wired than doctors! And guess what they’re doing? They’re visiting Dr. Google. If their team leader isn’t accessible, well, folks, it looks like patients are on their own turning to really helpful resources like ACORMEDgle, other patients, Your Flowing Data, and Without a doctor on the other end of these links, even those cutting edge, senior netizens are leaving us behind blinded by their dust as we’re struggling to write our own chicken scratch paper notes.

Doctors…eating the elderly’s dust isn’t your fault. You can’t work for free. And since the Feds define how we get paid (with this, not for this), we’re going to limp along, weighed down by our paper charts and federal bureaucratic initiatives that will soon face stiff resistance from the people who don’t kill golden geese, while society races past us in this era of profound changes in the way humans communicate. If only the way we get paid could be updated for the 21st Century, our patients wouldn’t be marginalizing our efforts. I can dream, can’t I?

Jay Parkinson, MD is a physician based in Williamsburg, Brooklyn. He works with Hello Health, an innovative healthcare start-up that matches online patient visits with convenient neighborhood locations. Jay will be a featured speaker at Health 2.0 Meets IX on April 22nd-23rd in Boston, where he will discuss the future of the physician practice in a Web 2.0 world and his firm’s vision for the future. Thinking of going? A limited number of passes are still available.

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Ajay Prasad

I totally agree with the data you have mentioned in your blog. The health sector has shown a tremendous growth and it is completely connected to the internet, social media and digital channels. Now patients are just a click away from their needs with the help for internet. Healthcare businesses can also reach to their untapped market of patient through healthcare digital marketing (

Medical Webexperts

A very true suggestion by you. Your article is clearly indicating the current situation that patient are facing. Beyond the fair price, the other most important thing that patient can come to know is the authenticity of the doctor. You can search over the internet regarding the information related to particular doctor. Their reviews from the existing or ex-patients help you determine the ability and excellence of the doctor. Beyond that website help patient fetch important information regarding the health issues they are facing. They can post their experiences with the situation and may get the reviews from the doctors… Read more »


amazing post


Why not use a web based method for searching for medical procedures and paying cash at discount. This makes perfect sense for the uninsured and under-insured. Did you read yesterday press release on Yahoo for

Peds Doc
Peds Doc

More often than not my pediatric patients’ parents show up in the office with an arm load of internet print outs about their child’s problem (or they call me in a panic later, after they “research” the diagnosis I made on their child). Invariably they read about some extreme case and I have to explain in detail why their child’s case is different from what they read. Patients should be directed to physician monitored and edited websites like, which can serve almost like a reference librarian and guide them to accurate information about their condition.


Patient-centered medical homes in the primary care setting are moving decision making to the patient along with the use of electronic medical records, e-prescribing and registries. So, there is a considerable amount of IT communication involved. Many of the details are succinctly explained on the TransforMED site.


On line communications between doctors and patientss is actually a complicated issue, given the variety of services that can be provided, and types of practices. Its therefore important that any system that’s set up is sufficiently flexible to accomodate the needs of the different patients and doctors. One on line service that does that is Its open to everyone, easy to use, and lets physicians decide on the types of services to offer, whether or not to charge for them, or how much. It also bills the patient if there is a charge. That way the patient can be… Read more »

John Butler, MD

I am an internist/geriatrician. I love the concept of project management applied to health care. A problem arises and tasks need to be prioritized and accomplished. This comes up so often, but the fragmentation and lack of coordination that is inherent in our individual services design creates a challenge. When care is complex, the result is often confusion for patients, and rework for providers- reimbursed for providers, but expensive and sometimes unsafe for patients. The burden of coordinating falls on the patient or for the fortunate patient, a healthcare savvy family member who can put it all together. Yesterday, I… Read more »

Eric Toczko

All of this information really makes people neurotic and makes people start self-subscribing…just what the big pharma companies want us to start doing, recommending drugs themselves.
-Eric T.


Solution to docs not getting paid for other than office visit and procedure – put them on salary. Jay, would you support salaried docs, or does that not fit with your business plan?

Michael Segal MD PhD

The online doctor should not just have a one-to-one connection with an individual patient. We need to break down the mindset of Health 2.0 communities being patient-only clubs, and find ways to get doctors helping in such communities. At the initiative of patients I’ve been helping in such ways on the Periodic Paralysis Association listserv. It is clear that patients are very appreciative of having doctors involved in such settings. We’re now preparing an “Owners’ Manual” FAQ for the most common of the diseases to help the patients get appropriate care, for example avoiding being treated as nuts with hysterical… Read more »

Dr.Rick Lippin

I wrote below in 1995-
New Roles for Physicians in the Information Age
-Information sorters, guides and interpreters
-Decision specialists/coaches
-Motivators of Behavioral Change
-Integrating patient’s values into health care
-Spiritual guides
-Care coordinators (especially primary care)
-Patient advocates
-Providers of emotional support (being there)
Dr. Rick Lippin

Healthcare Guru

It is nice article. Medicine, as I have taken, is an art and science mixture. There are things logical and then we have things that current knowledge is not sufficient to explain logically. It makes docs very vulnerable as they have only so much knowledge. Internet can help patient enhance med’s knowledge too. Why is it needed? Because, as smart as a physician may be, there is no checklist of items to do for every visit or disease. There is bound to be some misses and also they are bound to miss some of the information about disease and drug.… Read more »


Uhmmh … it is hard to offer a note of caution after all this unmitigated enthusiasm. First off all, Dr. Parkinson’s claim that only 9% of docs and hospitals use computers seems misleading. The link clearly refers to EMR, not computer use. I could be wrong (all hospitals I worked at in the last decade happened to have EMR), but I would bet that more than half of the hospitals have at least some partial computerized functions (e.g. labs) and easy web access to good sites like emedicine (free) or up to date (subscription). I don’t know how many doctors… Read more »


You’ve got to handle that patient (ok it me) gently, because we really think we know something when we come in. I have a great, well informed, well read Dr., and I now get it. His approach is lead – let me know we have a process, first, what is the chief complaint and the next two in line, I see him busy at the desktop entering data, he then doesnt let me go into my newly gathered google data, he starts asking me millions of questions, and honestly thats when I start to get it. He knows best and… Read more »