How the Internet Is Transforming the Physician-Patient Relationship

James G. Anderson, PhD, Professor of Medical Sociology, Purdue University, West Lafayette, Indiana

In This Article

Physician-Patient Conflicts

While these applications of health informatics are not designed to replace the physician in decision making and provision of care, some physicians question their effectiveness.[11] In 1 recent study, Forrester Research interviewed 40 healthcare executives and 20 physicians.[12] Physicians, compared with administrators, consistently rated the Internet as less useful in providing patient education, purchasing products and services, obtaining medical records, and processing insurance claims. One physician stated, "The jury's still out on the Net's cost-effectiveness in hospitals. Doctors are people whose time is worth a fairly substantial amount of money. Taking time from the highly remunerative practice of medicine to spend on computers, especially for surgeons, would have to have a fairly high ROI."

Collectively, only 9% of the respondents felt that physicians would personally answer e-mail messages from patients. Major reasons given by physicians for not using the Internet more actively in managing patient care have to do with time and compensation. Specifically, physicians indicated that they did not feel that they would be adequately compensated for their time and effort. Also, they didn't perceive that using the Internet would save them time or increase their productivity. One physician who was interviewed stated: "If I have to answer 30 e-mails a day, I'll get no work done." Another commented: "Basically e-mail is not a big winner for us... It's time-consuming, and we don't get paid to do it."

In the face of this skepticism, however, some healthcare providers are moving ahead with plans to incorporate the use of the Internet into the provision of care. Kaiser Permanente is spending over $2 billion to move all of its operations onto the Internet.[13] Kaiser is creating a computerized patient record for its 9 million members. Also, all 361 of its clinics and hospitals and over 100,000 physicians, nurses, and dentists will be able to communicate with one another and with patients. Members of the health plan can use the system to search online for health information, obtain advice from nurses and pharmacists, request an appointment, or join an online discussion group.


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