Two physicians affiliated with the David Geffen School of Medicine at UC Los Angeles argued repealing net neutrality may harm medical education in an April 11 op-ed for JAMA.
For medical trainees, the internet has provided mostly unfettered access to "dynamic bodies of literature," including online summary databases and clinical decision support tools, which help to inform trainees' patient care choices. However, this access rests on many of the regulations established under net neutrality, according to the authors.
Established in 2015, the Obama-era rules commonly referred to as "net neutrality" prohibit broadband companies from prioritizing or blocking some content over others. The Federal Communications Commission voted 3-2 to dismantle net neutrality rules in December, with the repeal slated to go into effect April 23.
"The repeal of net neutrality regulations creates an opportunity for [internet service providers] to intrude into medical decision making in a variety of ways," the authors wrote. "ISPs could contract with pharmaceutical companies to reorder search queries to promote certain drugs, limit access to sites advertising competing manufacturers' medications or hide open access research critical of a promoted therapy."
The authors also argued the repeal of net neutrality might affect open-access and nonprofit medical resources, which tend to be created by physicians and fueled by donations. These "small-budget, high-yield resources" may lack the funds to pay for the same prioritization as for-profit companies, and thus be relegated to the "slow lanes" of internet traffic.
"As some nonprofit resources facing prioritization fees fall into disuse, others may become subscription-based and pass costs down to the subscriber," the authors wrote. "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."
To access the op-ed in JAMA, click here.