The doctor–patient relationship is one of the most intricate interpersonal relationships. Its complexity is not a barrier but a reflection of its importance. In recent years, this relationship has undergone further evolution with the emergence of digital technology and the so-called informed and empowered patients, with its pros and cons. Modern medical practice experiences all kinds of patients. Some people place complete trust in the physician and adhere to their advice. On the other hand, there are some who arrive at the clinic equipped with web-based information with a preconceived notion regarding their diagnosis and treatment. These patients seek to participate actively in their therapeutic decision-making. The COVID-19 pandemic has been an epochal event in human history. While it unleashed immense human suffering, it has also engaged the human mind to embrace digital technology. The digital technology has revolutionized every aspect of modern life and health, which is also known as digital health. Digital health is defined as “the cultural transformation of how disruptive technologies, that provide digital and objective data accessible to both healthcare providers and patients, leads to an equal-level doctor–patient relationship with shared decision-making and the democratization of care.”1 Digital health is more than just a technology. From telemedicine and electronic health records to wearable sensors and AI-driven diagnostics, digital health tools are revolutionizing the delivery, monitoring, and experience of health care. Yet, among these innovations, the foundational pillar of medicine is being redefined: the doctor–patient relationship, which has been the heart of clinical practice. It is therefore essential to explore the effect of digital health on this fundamental relationship. Does it have the capaciy to enhance the bond, creating new opportunities for connection and understanding, or does it carry a more inimical potential to create distance, becoming a screen that separates rather than connects human beings? THE CHANGING LANDSCAPE OF HEALTHCARE The healthcare system has evolved with time. A patient visits a clinic, the physician listens, examines, advises, and treats. This interaction formed the foundation of trust and empathy. However, with the advent of digital health, today a patient can track their blood pressure at home using a connected device, consult a physician via video call, receive AI-generated health alerts, or access their full medical history on a mobile app. Electronic health records, for instance, allow clinicians to instantly retrieve patient histories, test results, and medication lists, reducing errors and supporting more informed decision-making. It allows patients to take control over their health, enabling personalized interventions. Simultaneously, it also allows physicians to have real-time data, with improved diagnostic accuracy, and better coordination of care. But what happens to the affection between the physician and the patient when much of the communication occurs via screen or algorithm? Can we safeguard the trust and empathy between the two in this era of digital health? The answer to this depends on how the digital health is utilized whether to strengthen or to weaken this doctor–patient relationship. The importance of digital health has become the center of discussion, especially after the COVID-19 pandemic. As per available data, there has been an increase in the percentage of people using the Internet for health-seeking behavior. Almost 80%–88% of the Internet users, use digital media to look up for health-related information.2 Digital tools like telemedicine had significant contribution to digital health due to its easy accessibility. A patient can consult the physician from miles away, regardless of the distance. This has helped in mitigating distances, especially for rural and semi-urban areas or geographically isolated areas. Tools like wearable sensors and access to the wealth of health-related information on the Internet enable them to have a better understanding of their condition. This ultimately leads to active participation of the patients in their care, contributing to shared decision-making. These tools even help in enhancing the communication between the doctor and patient, making it more frequent, timely, and convenient. CHALLENGES AHEAD: BARRIERS TO DIGITAL HEALTH Loss of human connection and digital divide In spite of several advantages, there do exist certain barriers of digital health to doctor–patient relationship. The most important being the sense of depersonalization. In traditional face-to-face consultation, certain clues like facial expressions, tone of voice, and body language helped in improving patient needs and care vis-à-vis in the era of virtual interactions, where screens create both physical and psychological distance, this element of human touch is lost entirely. Furthermore, over a period of time, such interactions happening solely on digital platforms lead to emotional blunting. Another important concern is the digital divide, wherein not everyone has access to the Internet, smartphones, and digital tools. Moreover, uneducated, illiterate, physically disabled, and super senior citizens may face hindrance to access the information. Trust privacy and ethical considerations Trust is the building block of the doctor–patient relationship, and its preservation is of paramount importance. With the integration of digital tools with health care, concerns regarding data privacy and security have come to the forefront. Breach of trust in the form of unauthorized data sharing can compromise this relationship. The patient must be aware about how artificial intelligence has been integrated into diagnostics and treatment and how the algorithms work. Establishing clear ethical guidelines and robust regulatory frameworks is essential to navigate these challenges. Simultaneously, the physicians must also be well equipped with the knowledge and skills to responsibly, ensuring the patients are well informed about their rights too. Increasing workload Many times physicians feel like become the “cogs in wheels” with constrained liberty to meet institutional and technological demands. The working hours and stressful conditions lead to physical and emotional exhaustion. In addition to it, poorly designed and inaccessible digital tools further increase the workload and decrease the efficiency of physicians, compromising patient-centered care. Therefore, being a 21st-century healthcare provider is extremely demanding. Lack of resources and reimbursements Resource limitations in the form of poor infrastructure create a serious obstacle, particularly in small clinics and rural healthcare centers, where they suffer from unreliable electricity supply, poor internet connectivity, and inadequate technical support. Establishing digital health systems requires a high cost of implementation and maintenance in the form of computers, servers, software, internet connectivity, cybersecurity, and staff training. Limited funding further slows the progress of digital infrastructure; therefore, these projects receive less support and remain ineffective. Lack of trained medical staff Many physicians, along with other medical staff, struggle to adapt themselves to digital healthcare tools. For example, some may find it difficult to communicate in a virtual environment. Technical failures can lead to delays, data loss, and reduced quality of care. Therefore, skilled professionals are required to manage systems, solve technical problems, and maintain cybersecurity, so that healthcare institutions can operate digital platforms efficiently. Resistance from physicians Many physicians are comfortable with face-to-face consultation and paper-based records rather than using technologies. Learning to use new digital tools could consume more time and effort, leading to more stress and resistance to adopt new approach. How to overcome these barriers? To overcome these barriers, so that the patient care is not hampered, the first and the foremost step is to strengthen the digital healthcare system. This is can be done by implementing secure data storage systems, encryption technologies, and cybersecurity measures to prevent breaches and unauthorized access. For the digital divide, expanding broadband access and improving network coverage can help ensure equal access to digital healthcare services for all populations. Training of both the patients and the healthcare professionals must be done on how to use digital tools. It can be done via regular workshops, educational programs, and moreover it can be also included in the medical curriculum itself, right at the undergraduate level. Governments should establish clear legal and standard regulatory frameworks for telemedicine, electronic health records, artificial intelligence, and data sharing. The way ahead! Certainly, the digital technologies are reforming the medical practice and physician–patient relationship. By strengthening and enabling patients to be actively involved in their own care, what is known as participatory medicine, this approach could be more collaborative and cooperative. Healthcare providers today are steadying many roles at a time – as learners, teachers, and caregivers, while continuously adapting to the evolving digital heathcare system. The era of digital health, therefore, should not only focus on equipping e-patients with information, tools, and technologies. It must also focus on empowering physicians, with the time, opportunities, and technological support. When thoughtfully integrated, technology can strengthen and enrich the physician–patient relationship, instead of replacing or diminishing it. Financial support and sponsorship None. Conflicts of interest There are no conflicts of interest.
Gautam et al. (Wed,) studied this question.