The doctor-patient relationship in the Web 2.0 era: an exploratory research on social repre-sentations, Internet mediation and trust

Author/s Elisa Colì, Fabio Montani, Rino Falcone
Publishing Year 2019 Issue 2019/2 Language Italian
Pages 25 P. 28-52 File size 293 KB
DOI 10.3280/PDS2019-002002
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The study investigated the relationship between general practitioner and patient in the Web 2.0 era, analyzing the social representation that the patient has of the doctor, the use by patients of the resources made avalaible by Internet and the influence on the relationship with their doc-tor, the patient’s trust in the doctor and the influence of the internet use. The research, carried out within the Local Health Authority of Savona, involved 112 people with an average age of 50 years. The data were collected through an ad hoc questionnaire, completed at the doctors’ offices. The results highlight the presence of a patient who takes an active role in the management of his health, using internet to look for health information, and evaluating skills and willing-ness of the doctor of which he chose to trust. A long-lasting relationship with the doctor and the presence of a doctor who devotes time to the patient during the visit are two important ele-ments that can mediate the use of the internet for the search of health information and for the management of the relationship with the doctor. Even if the patient uses the web to understand his symptoms and physician’s diagnosis, and sometimes is less compliant with the doctor’s prescriptions, the doctor, who is given a lot of trust, continues to play a central role in verify-ing the information found on the internet. The competence and the willingness resulted as im-portant elements to strengthen trust in the doctor and to make less necessary the use of the web to look for reassurance.

Keywords: Doctor-patient relationship, social representation, internet use, trust

  1. Abric J.C. (2001). A structural approach to social reprèsentations. In Deaux K. and Philogène G., editors, Representations of the social: Bridging theoretical traditions. Malden: Blackwell Publishing, pp. 42-47.
  2. Andreassen H.K., Trondsen M., Kummervold P.E., Gammon D. and Hjortdahl P. (2006). Patients who use e-mediated communication with their doctor: new constructions of trust in the patient-doctor relationship. Qualitative Health Research, 16 (2): 238-248. DOI: 10.1177/104973230528466
  3. Castelfranchi C. and Falcone R. (2010). Trust theory: A socio-cognitive and computational model. Hoboken: John Wiley & Sons.
  4. Chandler P. and Sweller J. (1991). Cognitive load theory and the format of instruction. Cognition and Instruction, 8 (4): 293-332.
  5. Choi N. (2011). Relationship between health service use and health informationtechnology use among older adults: analysis of the US National Health Interview Survey. Journal of Medical Internet Research, 13 (2), e33.
  6. Cipolla C., Corposanto C. e Tousijn W. (2006). I medici di medicina generale in Italia. Milano: Franco Angeli.
  7. Cipolla C. e Maturo A. (2014). Sociologia della salute e web society. Milano: Franco Angeli.
  8. Cohen R.A. and Adams P.F. (2011). Use of the Internet for health information: United States, 2009. NCHS Data Brief, 66 (7): 1-8.
  9. Emanuel E.J. and Emanuel L.L. (1992). Four models of the physician-patient relationship. Jama, 267 (16): 2221-2226.
  10. Erdem S.A. and Harrison-Walker L.J. (2006). The role of the Internet in physician-patient relationships: The issue of trust. Business Horizons, 49 (5): 387-393.
  11. Europ Assistance and CSA (2013). Health & Society Barometer ‒ 2013: 7th wave of the barometer. -- Retrieved from:
  12. Ferguson T. and Frydman G. (2004). The first generation of e-patients: These new medical colleagues could provide sustainable healthcare solutions. British Medical Journal, 328 (7449): 1148-1149.
  13. Fiscella K., Meldrum S., Franks P., Shields C.G., Duberstein P., McDaniel S.H. and Epstein R.M. (2004). Patient trust: is it related to patient-centered behavior of primary care physicians? Medical Care, 42 (11): 1049-1055. DOI: 10.1097/00005650-200411000-0000
  14. Fox S. and Duggan M. (2013). Health online 2013. Washington: Pew Research Center.
  15. Gfk Eurisko (2015). Health Information Journey – Canali e influenti nel decision making della popolazione italiana in area salute e benessere. -- Retrieved from:
  16. Gracia E. and Herrero J. (2009). Internet use and self-rated health among older people: a national survey. Journal of Medical Internet Research, 11 (4): e49.
  17. Hall M.A., Dugan E., Zheng B. and Mishra A.K. (2001). Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? Milbank Quarterly, 79 (4): 613-639. DOI: 10.1111/1468-0009.0022
  18. Hall M.A., Zheng B., Dugan E., Camacho F., Kidd K.E., Mishra A. and Balkrishnan R. (2002). Measuring patients’ trust in their primary care providers. Medical Care Research and Review, 59 (3): 293-318. DOI: 10.1177/107755870205900300
  19. Hart A., Henwood F. and Wyatt S. (2004). The role of the Internet in patient-practitioner relationships: findings from a qualitative research study. Journal of Medical Internet Research, 6 (3): e36.
  20. Hesse B.W., Nelson D.E., Kreps G.L., Croyle R.T., Arora N.K., Rimer B.K. and Viswanath K. (2005). Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Archives of Internal Medicine, 165 (22): 2618-2624.
  21. Kao A., Green D.C., Davis N.A., Koplan J.P. and Cleary P.D. (1998). Patients’ Trust in Their Physician: Effects of Choice, Continuity, and Payment Method. Journal of General Internal Medicine, 13 (10): 681-686.
  22. Iverson S.A., Howard K.B. and Penney B.K. (2008). Impact of Internet use on health-related behaviors and the patient-physician relationship: a survey-based study and review. The Journal of the American Osteopathic Association, 108 (12): 699-711.
  23. Jacobs W., Amuta A.O. and Jeon K.C. (2017). Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Social Sciences, 3 (1): 1-11. DOI: 10.1080/23311886.2017.130278
  24. Lan Y.L. and Yan Y.H. (2017). The Impact of Trust, Interaction, and Empathy in Doctor-Patient Relationship on Patient Satisfaction. Journal of Nursing and Health Studies, 2 (2): 1-7. DOI: 10.21767/2574-2825.100000
  25. LaVeist T.A., Nickerson K.J. and Bowie J.V. (2000). Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Medical Care Research and Review, 57 (1_suppl): 146-161. DOI: 10.1177/1077558700057001S0
  26. Mangone E. (2006). La strutturazione del ruolo del medico e la fiducia. Salute e Società, 5 (1): 1000-1017. DOI: 10.1400/6804
  27. Oliveira J.F.D. (2014). The effect of the internet on the patient-doctor relationship in a hospital in the city of São Paulo. JISTEM-Journal of Information Systems and Technology Management, 11 (2): 327-344.
  28. Pearson S.D. and Raeke L.H. (2000). Patients’ trust in physicians: many theories, few measures, and little data. Journal of General Internal Medicine, 15 (7): 509-513.
  29. Percheski C. and Hargittai E. (2011). Health information-seeking in the digital age. Journal of American College Health, 59 (5): 379-386. DOI: 10.1080/07448481.2010.513406
  30. Pescosolido B.A., Tuch S.A. and Martin J.K. (2001). The profession of medicine and the public: examining Americans’ changing confidence in physician authority from the beginning of the “health care crisis” to the era of health care reform. Journal of Health and Social Behavior, 42 (1): 1-16. DOI: 10.2307/309022
  31. QSR International (2012). NVivo 10 Computer software. Melbourne: Author. -- Retrieved from
  32. Ruberto M.G. (2011). La medicina ai tempi del web: medico e paziente nell’e-health. Milano: FrancoAngeli.
  33. Safran D.G., Kosinski M., Tarlov A.R., Rogers W.H., Taira D.A., Lieberman N. and Ware J.E. (1998). The Primary Care Assessment Survey: tests of data quality and measurement performance. Medical Care, 36 (5): 728-739. DOI: 10.1097/00005650-199805000-0001
  34. Shenk D. (1997). Data Smog: Surviving the Info Glut. Technology Review, 100 (4): 18-26.
  35. Thackeray R., Crookston B.T. and West J.H. (2013). Correlates of health-related social media use among adults. Journal of Medical Internet Research, 15 (1): e21.
  36. Thom D.H., Hall M.A. and Pawlson L.G. (2004). Measuring patients’ trust in physicians when assessing quality of care. Health Affairs, 23 (4): 124-132.
  37. Tyson T.R. (2000). The Internet: tomorrow’s portal to non-traditional health care services. The Journal of Ambulatory Care Management, 23 (2): 1-7. DOI: 10.1097/00004479-200004000-0000
  38. Verges P. (1992). L’évocation de l’argent: une méthode pour la définition du noyau central d’une représentation. Bulletin de Psychologie, 45 (405): 203-209.
  39. Verges P., Scano S. and Junique C. (2005). Ensemble de programmes permettant l’analyse des evocations. EVOC2005: Manuel [Entire program for the analysis of evocations. EVOC2005: Manual]. France: Aix-en-Provence.
  40. Vicarelli G. (2000). Fiducia e stima nei riguardi della professione medica in Italia. Un’interpretazione di carattere storico-comparativo. Rassegna Italiana di Sociologia, 41 (3): 389-412.
  41. Wald H.S., Dube C.E. and Anthony D.C. (2007). Untangling the Web-The impact of Internet use on health care and the physician–patient relationship. Patient Education and Counseling, 68 (3): 218-224.
  42. Ybarra M. and Suman M. (2008). Reasons, assessments and actions taken: sex and age differences in uses of Internet health information. Health Education Research, 23 (3): 512-521.
  43. Zamagni M.P. (2008). Contributo al rapporto medico-paziente. Psychofenia, 11 (18): 43-62.

Elisa Colì, Fabio Montani, Rino Falcone, La relazione medico-paziente nell’era del web 2.0: una ricerca esplorativa su rappresentazioni sociali, mediazione di internet e fiducia in "PSICOLOGIA DELLA SALUTE" 2/2019, pp 28-52, DOI: 10.3280/PDS2019-002002