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Internet medicine is coming: doctors protest

Posted By Brian Blum On January 26, 2012 @ 12:56 pm In Holidays,Israeliness | No Comments

In my last post, I wrote about how I managed to get an MRI done in a hurry by arranging it in Beer Sheva, rather than Jerusalem where I live. The trip was a schlep, but the best part of the experience was actually after the fact. Rather than needing to call the hospital for the results and then have them faxed to me, I was given a website, username and password and told to simply log in a week later, where my MRI information would all be online. I am happy to report that the system worked as promised. It’s not the first time I’ve been able to handle medical issues via my computer in Israel. I can routinely check the results of blood tests – they’re updated in real time – and I can also request and receive permission for a referral to a specialist and even make appointments without ever picking up the phone. Sounds like Israel’s HMOs are finally getting their digital act together. Which was why I was rather surprised to open the morning paper and discover that doctors and the Israel Association of Family Physicians were loudly protesting increased use of the Internet for the very functions I’ve found so useful. The reason: it’s likely to “downgrade the professional status” of doctors. The complaints so far are being directed at the Clalit HMO, probably following a very public advertising campaign to raise awareness among the public of the new services being offered. Clalit is the nation’s largest HMO with 3.9 million insurees. Listen to what some of the doctors quoted in the article are saying: “You no longer have to go to the doctor – the clerk in the branch will do what you ask via the Internet.” How is that a bad thing? It saves time for both the patient and physician. And “this campaign and others continue to destroy the image of the expert family doctor, which was created with great effort – the doctor who specialized for years and is a professional in his field and provides good medical care for his patients.” Oh really, how exactly do you spoil the image of the gruff, abrupt Israeli doctor with no observable bedside manners? Sure, the Internet has no bedside manner, but you don’t expect it to. The physician’s association was more measured. “There is room for online work alongside a family doctor, as well as for the use of various technologies, but… there should be limitations.” That is, “Internet medicine is good when it’s done in moderation. Look, no one is saying that a website can replace a doctor entirely, heaven forbid! If my Internet service provider says cough or bend over, I’m making sure that I’m still on the Israelity site and not some “other” URL. Still, anyone who has ever waited hours in a cold Israeli HMO clinic fighting with the other patients over who was there first (“I was after him” is as common at the doctor’s office as in the line in the supermarket), increased computerization is the last thing I’d want stifled. A Clalit spokesperson got it right: “We have to suit the service to a new generation that wants quick answers and quick service. Medicine is no different from other services, such as those of an electric company or a bank….why can you get forms on the Internet today from any government institution, and only in medicine will people have to continue visiting the clinic and waiting in line? In such a situation, the patient will also develop greater responsibility for his health.” The services offered by Clalit are still rather limited and can always be superseded by a doctor’s request – for example, in many cases you can renew a prescription automatically over the web, but the doctor can insist the patient come in for an appointment first. The real revolution – and the one the doctors probably fear the most – is when the HMOs start providing complete transparent access to your entire medical records. Imagine the whining that will arise when you or I can actually see what our doctors have written about us – entirely unmediated by the professional judgment of an inflexible stethoscope. Clalit hopes to launch the new service by the middle of 2012. Physician: heal thyself.

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