Thoughts About The Future: Health

Doctors Online

Our relationship with our doctors is changing due to new technologies. Increasingly, instead of going to visit a doctor for routine matters, you can go online, as described in a CNS News article. The big difference is that doctors can now use what is being called e-health or e-care to meet with their patients online to engage in video chats, participate in health checkups over the phone, or review the results of in-home health monitoring devices that send the data to the doctor over an Internet connection.

Doctors can even monitor and adjust the doses of medicine that patients get over the Internet. If patients have an automatic drug dispenser, a doctor can prescribe how much of what drug a patient will get and change or stop the dosage based on the information obtained from other health monitors.

The way this online health care works is that a special device is clipped onto the patient ’s skin that contains all the drugs prescribed by the doctor. Then, based on what the doctor prescribes, the device using an Internet wireless connection will adjust what it doles out to the patient. In turn, the doctor will get information on what to do for the patient through an electronic health record, which keeps track of the results from other devices measuring the patient ’s blood pressure and glucose level. Later, should the doctor want to talk to the patient, he or she can communicate through video conferencing, as well as by phone.

For example, if a patient has diabetes, the flu, or high blood pressure, the doctor can see how the patient is doing at the push of a few keys or the movement of a mouse on a screen. Then, based on this information, the doctor can decide what the patient should do and provide any prescriptions for drugs or further treatment—all electronically, of course.

This means that doctors and patients no longer have to see each other very much, because so much routine medical care can be practiced while the patient is in the comfort of his or her own home. Certainly, if necessary, this Internet medical treatment can pave the way for the patient to actually see someone by going to the doctor ’s office or to a hospital for further care aided by electronic devices for everything from reading blood pressure to taking brain scans. But otherwise, the system increasingly emphasizes getting health care from the comfort of your own home without needing to physically visit a doctor.

Ironically, this new focus on medicine is a bit like turning back the clock to the days when doctors did in-home visits, though back then they were actually there in person, whereas now these home visits are increasingly conducted via an Internet connection between the doctor in his office and the patient at home.

Though some might consider this distance between doctor and patient overly impersonal, this system has much to commend it. You don ’t have to take the time to physically go to the doctor, and you don ’t have to deal with the stress of getting there as you battle traffic pileups and bad drivers. Additionally, you might have access to the latest and greatest of electronic monitoring devices.

However, there can be a number of downsides. For example, what if you are dependent on all this electronic gear to communicate with your doctor and the power suddenly goes off? Or what if when the power comes back on again, you find that the power surge has blown the power system in your monitoring gear, much like what happens when a surge takes out a computer power supply or motherboard (which is what has happened to me when I left one of my printers on, and suddenly ZAP, during an outage in the neighborhood, the power supply went dead and has taken three months to replace). And then what if your equipment simply fails or becomes uncalibrated and gives a wrong reading?

If you ’re in a doctor ’s office, where the doctor is seeing you personally, he might realize there could be a problem if you are telling him one thing about your health while he is personally examining you which contradicts what he sees on the electronic device. This means he should do further checking. Perhaps seeing you on a video monitor might help to overcome that disturbance problem—and maybe some home equipment plugged into the monitor might be able to take your blood pressure and pulse or scan your open mouth and listen to you breathe. But if there is all this high-tech equipment between you and the doctor, maybe that could cover up some of the things that might be observed during an in-person doctor ’s visit. Not everyone may want all of that electronic medical gear in their house, and some may consider it overly expensive.

Also, this care over the Internet lacks one more important thing. Quite often medical treatment depends on the placebo effect—a very real effect that comes not from the specific pills or other treatments the doctor provides, but from simply seeing a doctor and getting his or her reassurance or from a belief that the pills or treatment will work. While some people might need that personal interaction with a trusted doctor to get that reassurance, some people might just as easily feel it and maybe even more so when they interact with a doctor over a computer screen.

So are all these changes making health care more electronic a good thing? I think the doctor is still out—or maybe the appropriate word now is offline—on that one. But the one thing that seems certain is that more and more of us will be getting our health care online and through electronic devices. And as we do, more increasingly we will need to personally see fewer doctors, which could be a good thing, if fewer doctors are available. Or then again, this new technology could lead to outsourcing medical care as well as many other jobs, so now, not only is the doctor that you see likely to be online, but outsourced to another country, too.

In any case, for the health care of the future, just turn on your computer and start the program. Wherever you are, the doctor is always in, er . . . online.