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In the information revolution, as in the industrial revolution, the challenge to primary care is profound. The enormous variety of informatics resources are coming to many patients. They are being encouraged to try to solve problems for themselves and only consult professionals when every thing else fails.

How many people here have been consulted by a patient with an internet printout?

Of course the process is more advanced in the states, partly for financial reasons where 23% of primary care consultations now have patients with information gleaned from the WWW. In the past, the medical profession has been held in high regard for the arcane knowledge we possess, soon it will be for our skills. Some skills will be of the psychomotor (plumbing) variety but much of it will be informatics skills. Machines will enhance our decision making skills but they if the patient is sufficiently worried to consult, they need the added value of a human to translate.