Doctors in a Wired World: Can Professionalism Survive Connectivity?

T he Information Revolution Has Raised Myriad questions about how the health care system will function in the future ( Gingrich and Magaziner 2000 ; National Research Council 2000 ). The consensus seems to be that new information technologies will significantly affect almost every aspect of health care, from the way that employers and individuals purchase health insurance to the way that doctors and patients provide and receive care ( National Research Council 2000 ). Although peer‐reviewed evidence to support these predictions is scarce, the available data suggest that the major health care actors are actively experimenting with the new capabilities to exchange information. A February 2002 survey by Harris Interactive ( www.Harrisinteractive.com ) found that 137 million Americans were users of the Internet and the World Wide Web and 110 million reported going on‐line at least three times a month to look for health care information ( Landro 2002 ). An earlier survey by the Pew Charitable Trusts reported that of those Americans who used the Internet for health care purposes, 92 percent found the information useful. The information revolution has the potential to reduce the asymmetry of information between patients and doctors and thereby to undermine a central pillar of physicians' claim to professional status: the possession of distinctive competence based on technical know‐how selflessly applied and collectively monitored. A close analysis of the information revolution's likely effects suggests that for some patients with some conditions, their access to more and better information will indeed reduce the magic, mystery, and power of the medical profession. However, the information revolution also offers opportunities for physicians to bolster the cognitive and moral bases of professionalism. To seize those opportunities, physicians must master new roles and skills and avoid unacceptable conflicts of interest.