"Supported by humanity's need for a healing class and by physicians' genuine technical competence, the [medical] profession will survive," says David Blumenthal, M.D., of Massachusetts General Hospital. "However, the work it does will likely change somewhat, as will its role in society and the relationships between doctors and patients."
Writing in the Milbank Quarterly, he explains that with an increasing number of patients having access to an increasing amount of health information through the Internet, doctors are losing their place in society as the exclusive source of medical knowledge. This trend has the potential, at a minimum, to greatly reduce the current imbalance in competence between doctors and laypersons, possibly resulting in a de-professionalization of medicine.
To illustrate, Blumenthal tells the story of a patient who gleaned from Internet chat groups that his prescribed dosage of medication for obsessive-compulsive disorder was higher than average. "He had, in effect, conducted a pilot study of patterns of care for OCD and, as a result, knew more about that topic than his primary care physicians did (and perhaps some psychiatrists as well)."
Even as the Internet allows patients access to information previously only available through their doctors, patients still trust the information they get from their doctors more than they do from Web sites, current surveys suggest. Because of this, doctors may fill the role of advisers or consultants, helping patients not only sort through the information that is available, but make rational decisions based on that information.
Blumenthal also notes that although a healing class has seemingly always existed in societies as far back as recorded history goes, doctors have only recently become the purveyors of scientific knowledge and experience.
This suggests that doctors will continue to have a place in society. "Patients will insist that a profession of medicine (or its equivalent) continue to exist, with all its rights and privileges, because people want access to a healing class," he says.
The mistrust in other sources of health information, well placed when those sources also advertise pharmaceuticals or sell health-related products, creates a circumstance that "enhances physicians' potential roles as disinterested advisers and patient advocates, the trusted marshals, if you will, of the Wild West of the information revolution," Blumenthal says.
However, even unjuried sources of health information, such as drug advertisements, can raise patients' awareness about treatments and other services provided by physicians. Alternatively, these informational sources may encourage patients to demand treatments and services that are inappropriate.
"In the future," Blumenthal concludes, "physicians must demonstrate that they are expert at marshaling all the available new information technologies for their patients' benefit -- that they are as good at surfing the Web as listening to lungs or performing an appendectomy."
FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Sue McGreevey at (617) 724-2764 or smcgreevey@partners.org.
Milbank Quarterly: Contact Bradford H. Gray, Ph.D., at (212) 822-7287.
Journal
Milbank Quarterly