Pathological loop and disruption of continuity of care in primary care: a mixed-methods study in Chile

Abstract

Changing doctors and abandoning prescribed treatment are usually analyzed as separate problems, overlooking how the digital ecosystem has reshaped clinical authority. In a mixed-methods study conducted in Chile in 2025-2026 with 350 people who sought health information online, both disruptions did not occur by chance: when people turn to search engines, social media and artificial intelligence to guide their health, distancing from the clinician and abandoning medical advice tend to occur together, though not symmetrically, since those who change doctors usually abandon treatment as well, while the reverse is less frequent. This co-occurrence, proposed as a care continuity disruption syndrome, remained low until patients began combining professional advice with digital criteria; at that threshold it rose sharply, reaching one in three people at advanced stages. The findings suggest that when the bond that legitimizes medical advice erodes, treatment tends to fall with it.