The doctor-patient relationship in digital health: possible effects on medical professionalism
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The essay analyses the potential challenges for medical professionalism stemming from those information and communication technologies (ICTs) that are directly deployable by citizens. In this field, we can list websites, social network sites and apps, which all challenge the sphere of jurisdiction and professional autonomy, especially in relation to medical knowledge, diagnosis and the delocalised production of clinical data and information via apps and the phenomenon of the quantified self. The nature of these technologies, along with other contextual factors, can foster a decline of the profession in the form of de-professionalisation, as postulated by Haug in the 1970s, by exacerbating the loss of a knowledge monopoly, while diminishing patients' faith and doctors' medical authority. Since the way in which technologies affect the doctor-patient relationship is not yet clear, medical professionalism is open to a second outcome, which is hybrid and technological: If ICT's potential were encompassed by the medical profession, we could expect a professionalism 2.0, characterised by the incorporation of technological skills, such as the co-management of eHealth and mHealth with the patients in the normal clinical decision-making process.