Int. J. Environ. Res. Public Health 2009, 6 515 health plans together with patients using the new tools [32]. This may involve overcoming the challenge that physicians possibly lack the skills to share health care information and decision-making with patients [33]. A somewhat related Norwegian study found that doctors were most often neutral (55%) as compared to positive (33%) when patients shared peer-generated health content with them [34]. Shared care may have previously connoted greater linkage between health system professionals for coordinated patient treatment [35] but is now also used to mean a direct partnering between physician and patient [36]. Exemplifying the shift to partnership models is the chairman of Radiation Oncology at the Montefiore-Einstein Cancer Center in New York, who tells patients that peer- reviewed information is important and says that “We have to acknowledge that patients do this research. It’s important that instead of fighting against it, we join them and become their coaches in the process [37].” Science, technology and business advancements could change health care so rapidly that many physicians, even those currently in medical school, may not be able to be fully prepared for the shift to genomic-based and patient-driven medicine without becoming actively involved themselves. Some physicians are starting to understand how health care models could change and seeing ways to offer value to patient-collaborators in the new system. There is a small but increasing number of specialty physicians at private clinics providing a variety of new health services including detailed genomic and blood biomarker analysis and preventive intervention programs, for example Omicia (http://omicia.com, genomics), the Frontier Medical Institute (http://www.fmiclinic.com, longevity), the Los Gatos Longevity Institute (http://www.antiaging.com, longevity) and Amen Clinics (http://www.amenclinics.com, neuro-imaging). In the intervening years before genomics and other biomarker diagnostics and treatments are proven and could be automatically administered via traditional health care channels, they will likely continue to be provided by private clinics as they are now. Consumer demand and the number of clinics could grow, and some sort of services standardization and certification may be appropriate for successful providers to distinguish themselves. From the growth of medical content in blogs, wikis and other Internet tools such as Twitter (http://www.twitter.com), it is clear that some physicians are participating in defining the broad range of new health care models and in applying Web 2.0 tools in medically relevant ways [38]. A study of junior physicians in the U.K. found that they used Internet tools as a means of being able to find relevant information more efficiently than from other sources [39]. The ScienceRoll Medicine 2.0 blog (http://scienceroll.com/medicine-20) tracks the status and development of some of these innovations. Some recent resources of note have included the Top 50 Health 2.0 blogs (http://acumeme.blogspot.com/2008/12/top-50-health-20-blogs.html), Top Physicians on Twitter (http://www.twitip.com/must-follows-on-twitter-physicians-triathletes-and-horse-people), the Clinical Cases medical blog (http://casesblog.blogspot.com) and a medical Wiki attempting to create a collective online memory for physicians, nurses and medical students (http://www.askdrwiki.com/mediawiki/index.php?title=Physician_Medical_Wiki). As some patients are seeing potential health benefits in forgoing their privacy on health social networks, some physicians are also adjusting to a new transparency regime. In the future, doctors could become as concerned about their public reputations as eBay sellers and others depending on online reputations [40]. Review sites for doctors with patient-entered data are proliferating (Figure 15): Yelp (http://www.yelp.com), Angie’s List (http://www.angieslist.com), HealthGrades