The impact of the Internet on healthcare in Ireland and the changing dynamic of the doctor-patient relationship in the context of Increasing consumer empowerment

Abstract

The development of the internet is a revolutionary force in human relations since it combines: a) the effects of the development of the printing press in communicating to a mass audience detailed information; with b) the immediacy of satisfaction of personal choice in communication between individuals and groups worldwide which the development of the telephone provided; together with c) the capacity to enhance the manner and impact of communication with visual and audio content associated with television and video. Millions of individuals and hundreds of thousands of groups are experiencing the benefits of use of the internet. This is driven largely by individuals and groups that are committed to achieving specific objectives, especially commercial objectives. However, the medium is in its infancy and is either not accessible by or is not utilized to anything approaching its potential by vast segments of the population. The Healthcare sphere is one of the underdeveloped areas in internet use. This thesis attempts to facilitate: (a) an understanding of the impact which the internet is having on the Healthcare area and the causes for its effects; (b) an appreciation of the potential impact which use of the internet can have in the Healthcare area. (c) the changing dynamic of the doctor-patient relationship in the context of the empowered consumer. The Healthcare area is unusual as a field of human endeavour because it does not fit easily into a commercial model. The purpose of the Healthcare project is to promote health and reduce the need for the "product/service". However, traditionally, the dominant culture of Western Healthcare emphasises medical or surgical intervention in the context of the doctor/patient relationship, which has at its core the special knowledge, skill and status of the doctor combined with the ignorance, needs and vulnerability of the patient. The pharmaceutical industry is the stakeholder in the Healthcare area whose explicit primary purpose is profit. Various cultural, ethical and political factors have combined to limit companies which produce medical products to promoting those products to doctors, not to patients. One consequence of this limitation is that the stakeholder with the most obvious commercial interest in maximizing the potential of the internet in the Healthcare area is not a "player" in the mass market. It is not surprising then that patients who have come in contact with the internet and begun to use it as consumers for various purposes including commercial, leisure and education, are beginning to behave as consumers in the doctor/patient relationship. They are a driving force in the development of the relevance of the internet in Healthcare because they recognize the potential benefits to them arising from the information at their disposal. The relationship is changing as a result. The advantages of patients/consumers gaining high quality information and the disadvantages arising from unreliable information present great challenges and opportunities for all stakeholders in the Healthcare area. However, exponentially increasing use of the internet by patients/consumers appears to be inevitable. The key to maximizing the benefits of the internet in the Healthcare area lies in the recognition on the part of each of the stakeholders of: a) the benefits which doctors, companies, interest groups and governmental/public health agencies can gain from the promotion of efficient, reliable and structured use of the internet; and b) the need for each of the stakeholders to commit the necessary time, effort and resources to achieve that result.