Moshe Leshno

1. יחסי רופא חולה בעידן המקוון Moshe Leshno

2. The Impact of health Information on the Internet on the Physician-Patient Relationship Source: Murray E. et al, Archives of Internal Medicine 2003, 163:1727–1734

3. Google search engine results in the display of a mere 2,610,000 sources of information. Even narrowing this down to ‘‘Irritable bowel syndrome’’ and ‘‘Patient Information’’ still leaves 49,200 pages.

4. Four Models of the Physician-Patient Relationship • Informative • Focuses on the facts; eschews moral judgment. The competent technical expert • Interpretative • Counselor or advisor. Promotes self-discovery of values. • Deliberative • Friend or teacher. Promotes admirable values; confronts harmful values. • Paternalistic • Guardian. Promotes welfare independent of current values Source: Emanual EJ and Emanual LL, JAMA 1992; 267(16) 2221-226

5. What Kind of Help Do Patients Want? • Who should: • Determine the diagnosis? • Determine what the treatment options are? • Determine what the risks and benefits options? • Determine probabilities of good and bad outcomes? • Decide how acceptable the trade-offs are? • Decide which treatment option should be chosen? Source: Deber , Kraetschemer, and Irvine, Archives of Internal Medicine 1996, 156:1414–1420

6. Patients want Healthcare Providers to Lead Problem Solving

7. … And Want Input on Values

8. The Impact of health Information on the Internet on the Physician-Patient Relationship • Whether patient’s access to large volumes of information will improve their health? • Whether the variable quality of the information will have a deleterious effect • The effect on health disparities • Whether the physician-patient relationship will be improved as patient become more equal partners, or damaged if physicians have difficulty adjusting to a new role Source: Murray E. et al, Archives of Internal Medicine 2003, 163:1727–1734