In the past 10 years, Internet has become one of the major sources of medical information. According to an ONTSI (the Spanish National Telecommunications Observatory and Society of Information) survey, 64% of 55000 respondents had access to Internet, and 43% of them used it on a daily basis.1 They mainly used the Internet for searching for information of any type, followed by consulting electronic mail, and reading online magazines and newspapers.

Although responders reported that their principal source of information for health-related matters was healthcare professionals (88%), up to 50% of users searched the Internet to compare this information with other sources.

In the case of a specific disease, Internet users mainly searched for the definition, symptoms and diagnosis of the disease (40%), healthy lifestyles (17%), medications (16%), alternative medicine (3%), and references centers or institutions (4%).1 Internet is used not only as a search engine: 35% of users use it to manage their medical appointments, consult their medical e-records, or to perform other procedures online.

Currently, Internet users have 2 main sources of information: public websites (institutions, hospitals, medical publications, etc.), corresponding to 41% of traffic; and private sites such as television channels, the healthcare sector (nutrition, sport, etc.), social media, and patient associations.

The ease of access to information has prompted several groups to study the impact of this availability on patients and their knowledge of their disease. Investigators Kothari M and Moolani S2 administered a pre-post questionnaire and found that a guided Google search increased patients’ knowledge of the causes and aggravating factors of their strabismus. Similar results were published recently by Al-Silwadi FM, et al.,3 who reported the findings of a study in a pediatric population scheduled for fixed orthodontic treatment. Parents of the control and intervention groups were both given oral and written information about the procedure in the clinic, while the intervention group was also invited to watch several explanatory videos on YouTube during the 3 weeks prior to the procedure. The intervention group was more knowledgeable about the technique their children were about to undergo and about post-procedure care than the control group.

It is clear, then, that providing patients with selected, accurate information via the Internet improves their knowledge of their disease. Unfortunately, this is not the case with all Internet searches, since not all the information can be considered valid.

According to the ONTSI,1 users have little confidence in the information obtained from the web (3.85 out of 10), and this is one of the major obstacles to the use of this source of data, along with other factors such as: limited searching skills, anxiety, time required, conflict between information received from the physician and information retrieved from searches related to mental health matters.4

An independent, well-informed patient, meanwhile, can jeopardize the physician-patient relationship, particularly if the physician feels that their authority is being challenged.5 In a survey of physicians conducted by Antheunis et al.,5 moreover, 38% of respondents stated that visits were less efficient if the patient brought along information, and even more so if the patient requested something inappropriate or the physician felt challenged.

Patients are usually too embarrassed or afraid to admit to the doctor that they have searched for information on Internet. In contrast, information found on the Internet can be helpful in informing the physician when a family member is present during the visit or if the patient comes across a warning on a website that should be notified to their doctor.

In conclusion, our patients or their family members search for health-related information on the Internet. Access to useful, updated information improves the patient's understanding of their disease and their adherence to therapy, and puts them in contact with other patients with similar diseases, creating networks over which valuable information can be disseminated.