The changing doctor-patient relationship: A move to anytime, anywhere

Telemedicine has been around long enough for us to see the many benefits of its uses (such as responsiveness and cost effectiveness). Telepsychiatry, although still a new concept, has great potential to reshape the way mental healthcare is accessed and delivered. With the use of the Internet and telepsychiatry factors such as distance, cost and the added element of stigma for some potential psychiatric clients, could be either vastly reduced or removed all together. In this chapter we will address the use of the Internet in the evolving relationship between mental healthcare providers and patients through five questions. The first question will explore how the Internet has changed the expectations and behaviors of patients, who now have much faster access to the latest information on treatments, clinical trials and the ability to share their experiences with others. The second question looks at who is using the Internet for healthcare and what is done with the information found online. Third we discuss what mental healthcare services are offered online and the effectiveness of these services. Fourth we compare the current and past models of the doctor-patient relationship in which we see a shift in the delivery of mental healthcare from the gold standard (face-to-face) to E-therapy (videoconferencing, E-mail and Instant Messaging). Finally we assess the benefits and potential downfalls of using the Internet in the doctor-patient relationship focusing on issues such as distance, cost and ethical considerations.