Introduction

Innovative medical apps are developing apace and being recommended to patients by clinicians,1–4 yet patients' pre-existing and autonomous engagement with internet information is not widely accepted into the consultation. Mainstream medical practice has not yet adapted to the ubiquitous use of the internet by patients. In failing to embrace the internet-informed patient (IIP), the medical community fails to maximise the learning opportunities that accessible, high-quality information offers patients. It also fails to support doctors who are frustrated or overwhelmed by the IIP. Most critically, this means we fail to provide truly patient-centred care; the patient's decision to search for information, the types and amount of information obtained and choice to discuss this information with a doctor reveal a great deal about what matters to the patient.

Definitions

Information literacy (IL) is: ‘an understanding and a set of abilities enabling individuals to recognise when information is needed and have the capacity to locate, evaluate, and use effectively the needed information’.5

The IIP is: a highly informed patient, possibly confused by the rich range of information available, and who may be dynamically interacting with the web around their problem, for example, undertaking self-assessment and seeking support and advice from internet communities. (Definition developed from integration of major elements from the evolving literature.)

There is an extensive body of research on doctors' reaction to IIP. Researchers have found that some doctors enjoy the challenge of an IIP and are positive about the potential for greater patient education and involvement generated by the internet.6 Unfortunately, reports of negative reactions to IIP currently dominate, with the literature reporting doctors' reactions as frustration, irritation and even outright disgust. The online activities of an IIP are casually disparaged (eg, by sarcastic ‘Dr Google’ comments), or simply ignored. There is an urgent need to help …