Medical Professionalism in the Internet Age

Medical professionalism encompasses the conduct and practices of physicians, both as individuals and as a collective organisation.Professionalism enhances the trust and confi dence of patients and society in doctors.For a profession that deals with decision making in an environment fraught with medical uncertainty and information asymmetry between the doctor and the patient, a reasonable degree of trust held by patients that medical practitioners will act in their best interests is critical.But the fi duciary nature of this relationship has come under increasing pressure as the rapid advance in information technology threatens to revolutionise the mode of engagement between patients and doctors, thereby presenting new challenges to the traditional boundaries of the doctor-patient relationship. 1ince the Internet's offi cial implementation in 1982, and its popular expansion in the 1990s, it has produced a momentous and dramatic effect on culture and commerce. 2he Internet has become a seemingly indispensable part of the modern life, fi nding its place and application in banking, dining, shopping, vacations, travel, and in maintaining social contact.Electronic mail (e-mail) and the World-Wide-Web (WWW) have revolutionised communication, such that it occurs at a previously unimaginable speed and volume.In recent years, online social networking forums such as Facebook and MySpace have become extremely popular as they raise further possibilities and complexities in how a doctor and patient can communicate.Although no local data are available, a recent study in the University of Florida, Gainesville, USA suggests that nearly two-thirds (65%) of medical students, as well as a growing number of residents (44%), have a personal profi le and regularly use Facebook. 3It is not unexpected, therefore, that such online social networking platforms will soon be adopted and accepted by technology-savvy doctors and patients as a means of engagement.While information technology in medical practice offers exciting possibilities in improving the effectiveness and effi ciency of healthcare delivery systems, concerns have been raised, particularly over the effects on medical professionalism, and integrity of the doctor-patient relationship.Such unease also occurs when medical