Table 1.

Physician perspectives on Internet-based health information introduced by patients

Theme	Description
Perceived reactions of patients	Physicians discussed various reactions of patients to the Internet health information brought to medical consultations. Some patients were perceived to have emotional reactions (confusion or distress) concerning the information they read. Others were perceived to have used the information for self-education or for self-diagnosis, with or without self-treatment; the latter group was perceived as challenging.
Physician burden	The introduction of Internet health information into the medical consultations was generally perceived as a burden, attributed to uncertainty about the website validity, limited Internet skills and/or access to up-to-date resources, lack of incentives, and time constraints.
Physician contextualization and interpretation	i) New role Physicians perceived that a new interpretive role was added to their clinical responsibilities when patients introduced the Internet health information into the medical consultations. Although most of the physicians felt obliged to carry out this new responsibility, the additional role was often unwelcome based on the reasons described above. This was further compounded by perceived difficulties in interacting with challenging patients who made erroneous self-diagnoses and/or treatment plans based on Internet health information. ii) Resistance The new role was viewed as a particular burden for older physicians, compared to recent graduates. iii) Strategies Physicians discussed various strategies to cope with the new role. These approaches reflected a collaborative (eg, recommending reliable websites, asking for a follow-up visit) and defensive (eg, referring patients to specialists, suggesting extra charge for time) stance towards the new role.