10 A number of recent studies have further examined the reliability of such medical information and found less than desirable results. Culver et al., for instance, examined an online discussion group and found that 90% of the medical advice presented was offered by contributors with no medical background.32 A study by

Impicciatore et al. found that less than 10% of patient-oriented health websites adhered closely to published guidelines, with some even suggesting potentially harmful therapies.33 Consequently, physicians remain wary of these tools and seem additionally concerned Inhibitors,research,lifescience,medical over the possible impact that inaccurate and inappropriate internet information may have on their BIBR 1532 Patients and their interaction, believing such information gives rise to false hope, anxiety, and knowledge.6 Patients and physicians thus remain somewhat at odds over how to incorporate patient-researched Inhibitors,research,lifescience,medical medical information into the clinical encounter. Though physicians have largely shown discomfort with Inhibitors,research,lifescience,medical patients utilizing outside information as tools, patients continue to express a strong desire for greater physician involvement in their own searches for information.5,34 Consequently, there is a pressing need to address this issue in an effort to assist physicians in preparing for

this new dimension in modern medicine. Inhibitors,research,lifescience,medical THE ADDED DIMENSION IN PATIENT–PHYSICIAN INTERACTION: PATIENT MEDICAL KNOWLEDGE

In previous models, the impact of patient medical knowledge was not formally incorporated. The flow of medical information was assumed to move only from physician to patient, but with information becoming increasingly available to patients, such an assumption is no longer reasonable. Patient familiarity with technical material has begun to significantly influence the dynamic of patient–physician interactions. As such, we complete our model of patient–physician interaction with the addition of patient medical knowledge as a third and final Inhibitors,research,lifescience,medical axis. Patient medical knowledge thus joins patient values and patient autonomy as the central variables considered oxyclozanide in our discussion. The essence of our model design is shown in Figure 3. Two additional examples of patients, for whom medical information has a substantial impact on care, will be discussed. Figure 3 Our model. The first is a patient who arrives with a significant degree of medical knowledge after being diagnosed with a rare disorder and actively pursuing information pertaining to their syndrome, the “informed patient” (C in Figure 3). In reality, the informed patient is becoming much more common and represents a significant challenge to the traditional modes of communication between patient and physician.