Limitations of Online Medical Care: Interpersonal Resistance and Cultural Solutions in the Face of Technological Advances
This paper examines the resistance of physicians and patients to an online medical consultation program launched in 2009 by a statewide health care service organization in Hawaii. The official intent of the program was to reach underserved clients residing in areas facing increasing shortages of primary care clinicians. The online interface allows clients to consult for an initial flat fee with on-call Hawaii based health care professionals by email, videoconference, or telephone. This case study highlights the themes of this year’s conference about the disjunctions between evolution and revolution. In particular, the intimacy and necessity of interpersonal trust for effective medical consultations rests on face-to-face interaction over multiple sessions, or an evolution of conventional medical practices. Yet, online medical care’s inherent depersonalization of medical care reflects health care’s revolutionary future. The paper offers some solutions to this dilemma, and ends with the implications of differential valuation of ethnographic research by non-practitioners, and its impact on how we judge our own institutional value.