Untitled - socium.ge

e-health networks and social transformations 305The incursion into centralized care by a decentralized medium has the potentialto affect social relations among multiple stakeholders. Anderson et al.(2003), in a study of unsolicited patient e-mails at a university dermatologicalhospital, observed that, over time, the tenor of e-mail content shifted frompatients’ self-perception as passive recipients of medical care to activeconsumers and demanders of health information. Anderson et al. (2003)attribute this shift to at least four factors.• Both patients and physicians perceive greater dissatisfaction withmedical services due to the limited time patients have with physicians.In all, 93 percent of physicians believe that many serious problemscould be avoided with more discussion, according to a 1997 Harrisstudy. However, 67 percent of the same physicians note that not havingenough time to spend with patients is a very serious problem (cited inRice, 2001). Hence, the Internet may provide a way to increase communicationwith one or more medical sources.• People feel the cost-saving pressures of healthcare plans, and thus takequality control into their own hands. Surveys suggest that about 43percent of US adults are not satisfied with their doctor’s accessibility,while the Internet is available around the clock, every day (Reents andMiller, 1998, cited in Anderson et al., 2003).• Increasingly, legal and ethical standards require patients to makeinformed choices. Yet it is difficult for them to be as informed as theywish. For instance, in a 2002 survey of Canadian cancer patients, only54 percent who wanted information about their disease felt that they hadobtained an adequate amount of information from their healthcareproviders (Chen and Siu, 2001). Given this perceived need, many willbe turning to the Internet in order to meet their information needs aswell as their perceived responsibilities.• There is simply a new wealth of accessible and inexpensive sources ofinformation. Thus, there is a reluctance to accept one physician’sdiscouraging prognosis or to rely solely on a single traditional source.On a typical day, 6 million Americans seek health information online,more than the number who visit or contact a physician (Pew, 2002), and48 percent of health seekers have looked for information about alternativeor experimental treatments and medicines. Although 83 percent ofpatients continue to rely on their doctor as the main source of information,71 percent search elsewhere.Health seekers are increasingly bringing Internet information with them to theirdoctor visits. Their motivations include seeking to increase their (1) time withthe doctor, (2) level of informed decision-making, and (3) individualization of