journal of digital research & publishing - The Sydney eScholarship ...

1 P M J O U R N A L O F D I G I T A L R ESEARCH & P UBLISHING
has arguably been partly facilitated by the increasing amount of health information
accessible by the public which has previously been limited to health professionals. This
increasing access to information has resulted in a change to the medical­knowledge gap
between health professionals and the public (Hardey: 1999,2001). Lee hypothesises that the
information availability of the Internet “facilitates the breakdown of health professionals’
monopolies over their own knowledge base” (Lee, 2008: p.451).
Gerber and Eiser (2001: 2) suggest that with information from the Internet, patients
“potentially have a different position in the decision­making process; possessing both
preferences and knowledge prior to any physician contact’’, however they acknowledge
that having this information does not automatically mean that the patient will want to
participate in decision­making processes. Similarly, Segal cautions against making a
direct link between information availability and the “empowered patient” (Segal, 2009),
however it will be clear when this paper looks at the case of thyroid patient advocates that
many of the issues surrounding consumers’ increasing access to information (including
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Nevertheless, it is clear that information availability is leading to a challenge of medical
authority, at least in regards to the knowledge gap. Lee argues that use of the Internet
“may strengthen people’s ability to question health professionals and increase people’s
skepticism about health professionals”. (2008: p. 461).
Other factors contributing to a democratisation of medical power include the ability of
patients to order medications on the Internet without a prescription (often, this is perfectly
legal depending on which country the pharmacy is in and which country the recipient is in)
and the ability to order diagnostic tests over the Internet in numerous countries without a
doctor’s involvement. These activities were possible before the Internet, however it is not
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Some scholars suggest that a substantial cultural shift, mainly due to the effects of the
Internet, is taking place, transforming the traditional doctor­patient relationship into
something more akin to a partnership in many cases (Crooks, 2006), making consumers
more critical and “aware that doctors are not ‘gods’, but human beings who make errors”
(Anderson, Rainey and Eysenbach, 2003: p.72). Gesler (1999: p.22) contends that “power
relationships can be contested and difference can be made into a positive force for good”.
Makoul (1998) developed a conceptualisation identifying two types of patients: physician­
reliant and self­reliant, however both of these still involve the doctor to differing extents.
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