Net Neutrality Repeal and the Potential Harm to Medical Education

Journal of the American Medical Association (04/11/18) Cuk, Natasha; Robinson, Colin L.

The ability to access and synthesize information from large volumes of literature is an essential part of effective patient care, note Natasha Cuk, MD, and Colin L. Robinson, MD, MPH, at the David Geffen School of Medicine, University of California, Los Angeles. In particular, medical trainees rely on online summary databases and decision-support tools to help ensure accuracy in clinical decision making. Some evidence suggests that these tools improve patient outcomes when compared with traditional educational resources. Changes to net neutrality policies recently approved by the Federal Communications Commission (FCC) could substantially alter this landscape, assert Cuk and Robinson. In the past, the FCC has prevented internet service providers (ISPs) from influencing search queries, "throttling" internet traffic on the basis of content or blocking applications owned by a competitor. In the healthcare arena in the post-net neutrality world, ISPs could potentially relegate online references and clinical decision-support tools used by trainees to "slow lanes" of internet traffic. Moreover, the costs of ensuring "priority access" would become the responsibility of the individuals creating these tools, such as physicians who rely on the assistance of donations to provide high-quality, well-referenced information at no cost to the medical community. Smaller or less well-funded county, community and rural training programs may not have the resources to pay for even the most basic content, increasing education disparities depending on where physicians train and practice. According to the authors, "Medical trainees may encounter barriers to their continued education while seasoned clinicians may see increased costs or loss of access to online resources that they have been using for years."

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