As my colleague Allwyn pointed out in his post from Mumbai, nowadays some people are asking themselves “Can I still trust my doctor?”. Trust has always been the base of the relationship between doctor and patient, but how’s the web been influencing this trust-based relationship? More and more people are searching for health information online. So, can we can we trust the “cyberdoctor”?

Trust in information sources is experiencing a global decline, according to 2009 Edelman Trust Barometer. However, trust in digital channels is still important, with Internet search engines as the most trusted (35%).

These results are on line with the trend we are experiencing in Italy, as described in details by the brilliant article titled “Doctor Web”, published on January 12th on the leading Italian daily newspaper “Corriere della Sera”. As the journalist explains, about 4 million Italians use the web - not the doctor - as the first information source for health issues, with a considerable increase from 2005, when they were only 2,8 % of population, to 13% in 2008. But the really surprising story is that one Italian out of 10 comes to contest the doctor’s diagnosis based on medical articles and researches read online. A research by Censis for the national Biomedical Forum shows that about 20% of Italians go online as first choice when looking for health services, 12% discuss with their doctors the results of their own online searches and 12,7% verify on digital sources their doctors’ diagnosis.

Well, it shouldn’t be such a big surprise since there are even 52 million results googling the Italian word Salute (Health). Italian doctors tell about patients criticizing the last stent chosen for their heart disease because of researches they’ve done online; drug-addicted patients buying online miraculous therapies and receiving veterinary ones; hypochondriac people asking for exams since they believe to suffer from symptoms they discovered on the internet.

The new frontier of digital health in Italy seems to be the “cyberdoc”. There are over 1.000 online communities discussing health issues online in Italy and several of them are creating a new cyber-relation between patient and doctor. For example, the community www.medicitalia.it has 60.000 visitors per day and 3.000 subscribed physicians, giving medical consultancy to patients through the web. But how can we trust those health information sources? Several health websites have asked for some kind of quality marks in order to increase trust for their visitors. Maybe the most popular is the Honcode by the Health on the net Foundation, which is applied by 4.000 sites worldwide.

This new kind of medical relationship is probably easier, faster and more direct than the traditional one, but I don’t believe the cyberdoc can be the only future owner of a trusted health relationshjp. The Internet is of course the best health democracy, as very useful for conscious patients to engage relationships with doctors, have different and wider point of views and, if possible, make their own choice. However, no internet search can replace a real dialogue with the physician. A reliable and trustworthy diagnosis can’t be made only online. Even if information is virtual, danger can be real!