It assumes that, medically speaking, physicians are smart and patients aren’t. Doctors wait for sick people to come to them and tell their patients what to do, one-on-one, face-to-face. Patients play little or no role in deciding their own treatment plans. As one physician put it to me: “Today’s healthcare institutions are like the old media: centralized, one way, immutable, and controlled by the people who created and delivered it. Patients are passive recipients.