Doctors
From guard to guide: 25 years of evolution of doctor-patient communication in the digital age
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Until 25 years ago, patients would come to the office with a sheet of symptoms and a handful of questions. Today, they often start with a Google search engine, a web forum or a health app. They come with a ready-made diagnosis, results from wearables and expectations of communication here and now. During this time, doctors have gone from the “guardian” of access to medical knowledge to the role of a guide who helps the patient navigate the complex health system and information chaos.
In this article, you will read about how doctor-patient communication has changed in recent decades and what this change means for your relationship with patients [1].
At the turn of the century, the main place of the doctor-patient relationship was the office. Communication was punctual and synchronous: contact meant a visit, sometimes a phone call. The patient's notes ended up on a piece of paper or in a binder. The doctor was the source of knowledge, decision and diagnosis. The patient came for an answer, the doctor was the “expert” at the top of the hierarchy. Trust was built face to face.
At the beginning of the second decade, the wave of digitalization began. Electronic medical records (EHR), patient portals and the first applications appeared. Communication gained new channels, but these often served mainly administration: access to results, confirmation of visits, one-way messages. Doctors spent more and more time at the computer, less and less with the patient. The relational space was shrinking and patients with chronic diseases were arriving.
The COVID-19 pandemic has changed everything. Doctor-patient communication moved to the Internet almost overnight. Video consultations, teleconsultations, prescription machines and symptom monitoring apps flourished. On the one hand, accessibility increased: the patient could consult without leaving home. On the other hand, there was a lack of structure and tools to support a real relationship. Conversations have become even more punctual and transactional.
Studies cited in JAMA [1] show that patients increasingly value frequent, brief forms of contact: text messages, notifications, chats. In the age of chronic diseases, patients need to be guided, not just consulted. The key becomes not the length of the interactions, but their rhythm and relational continuity. Meanwhile, doctors are overloaded. They do not want consecutive communication channels that generate expectations, but do not give time or structure.
In the 1990s, the doctor was a source of knowledge. Today, the patient has access to it himself, but he needs someone to help him separate the truth from the information noise. He needs a guide. The doctor becomes a partner in the management of the disease, not just the diagnostician. Especially in chronic care, relationship, contact and support at many levels become crucial: educational, emotional and practical.
The JAMA report makes it clear: the quality of communication correlates with patient health outcomes more than many pharmacological interventions. Meanwhile, there is still a lack of systemic solutions to support this communication on a daily basis. It is not the number of tools, but their quality and embedding in the doctor-patient relationship that determine the effectiveness. Innovation is not a chatbot, but the ability to build trust through chat.
In this context, the Doctor.One platform was created. Not as a symptom monitoring tool, but as a relational space. It is the doctor who decides who he receives, when he responds and how he conducts communication. It is the patient who has a permanent place of contact and a sense of presence. The model based on asynchronous chat allows you to build continuity without overloading. The educational and supportive role is taken over by the care coordinator so that the doctor can focus on medical decisions.
Doctor-patient communication has come a long way from point visits to micro-interactions in the digital world. The role of the doctor changes from the “guardian” of information to the guide of the relationship. In this new model, tools are needed that support, not interfere. Which serve the relationship, not just the transmission of data.
Technology can be a threat to empathy — but it can also be a tool of it. It all depends on who runs it.
Therefore, the future of health begins with a doctor. From his relationship with the patient. And from deciding what kind of communication he wants to build.
1. Song M, Elson J, Bastola D. Digital Age Transformation in Patient-Physician Communication: 25-Year Narrative Review (1999-2023). J Med Internet Res. 2025 Jan 16;27:e60512.
