The Internet is for P-p-persuasion

[box] Oscar To explains how internet etiquette can impact on doctor-patient interaction [/box]

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“Here, let me google the symptoms for you”

In the modern day, the internet has allowed us to become ever more connected to people from all over the world, many of which we will never meet. Social media platforms have given us an unprecedented ability to expose ourselves to the world, be it in our appearances or our musings of day to day life. The internet has also flourished as a platform that allows us to discuss our ideas with a wide range of people.

The nature of these discussions leaves something to be desired though, often with a whole range of logical faux-pas. These can often be the only exposure people have to debate and argument, and it is therefore imperative that one is able to assess the flaws that this medium has. After all, if your patient comes in and trolls you, you better know how to deal with it.

Primarily, the medium of the internet generates a unique paradox where we are both an anonymous unknown and also a knowledgeable expert. In the online sphere, the simple act of posting a comment instantly gives it legitimacy no matter what the content. This means your average joe can claim whatever they like until someone can actually disprove them (or at least appear to do so). Furthermore, you are not dealing with a single anonymous expert but potentially hundreds.

With hundreds of responses, how are people able to make sure their comments are noticed? Writing a long piece rarely works; the average reader will skip the wall of text and move to the next one. Indeed, the best way appears to be to write something vitriolic to attract a response. This leads to a positive feedback cycle where it seems the best way to attract attention is to send out death threats, preferably to everyone.

In addition, due to the pure mass of responses that need to be read, the most common viewpoint becomes the one that is accepted: a virtual human wave attack. The internet also forms localised regions of people with similar viewpoints tend to cluster. This combination makes it very difficult to challenge opinions as a result, with reasonable points being flooded with hate fuelled vitriol.

Furthermore, with social media, people are able to form a collective mob rule on the opinions of their friends by exporting followers sharing their views and effectively police opinions of their friends who wish to avoid conflict by censoring themselves from articles that could generate online controversy.

In topics where there are two prevailing view points, both sides will often as a result make bold extreme claims, whilst trying at the same time to discredit every point the other side makes. This makes for bold vocal shouting matches between two sides whilst no moderating consensus is ever achieved. Moderates hoping to find a middle ground are squeezed between two extremes.

As a doctor, it is necessary to realise that internet discussions form an increasingly large amount of exposure for people’s experience of interaction and dispute. As a result, one may well find that habits may be picked up subconsciously. This is most important in regards to the way we communicate with patients, particularly if any sensitive disputes arise. In these situations, the patient may push for the most extreme point to test the water. What is necessary is not to fight fire with fire but to promote what the internet does not: a balanced discussion. Address their points, concede concerns the patient holds, and gently move them away from the edge, towards your view. A consultation is not a battle of the wills, it is a shared partnership that aims to give the patient the best healthcare for them.

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