Dr. Rahul Parikh has written an interesting piece on the "Uberization" of medicine.  By this expression, Dr. Parikh refers to app services that some start-ups have created to allow doctors to perform freelance medical consultations over the Internet.

For example, a person experiencing a rash might sent a picture of their skin to a doctor by smartphone rather than going to the bother of making an appointment, travelling to the doctor's office, waiting, etc.

Dr. Parikh raises a variety of considerations.  Some of them relate to the issue of the neutrality of technology in society.  It is sometimes claimed that technology is "just a tool", that is, it facilitates activities that people engage in but does not fundamentally alter them or the people using them.  Dr. Parikh points out ways in which Uberizing medical consultation is not neutral in this sense:

  1. Just as Uber is looking into getting rid of drivers through self-driving cars, medical app services are looking into replacing doctors through AIs, that is, software that can diagnose ailments via photographs, recordings, etc., submitted by smartphone.
  2. Such services would also increase use of medical services.  One study showed that 9 out of 10 virtual consultations were for occasions that would not have prompted a visit to a physical clinic.  Making consultations easier will, perhaps vastly, increase use of them.
  3. Such services also tend to unwind the traditional doctor-patient relationship.  That is, when people consult a doctor online, they are not very concerned with consulting the same physician each time.  The physician they consult could be different on each occasion.

Clearly, adoption of virtual consultation services could profoundly change what a medical consultation is.

Having accepted that such changes are not neutral, the question becomes: Are they for the better or worse?  As usual, the answer is that the new situation involves trade-offs relative to the old one. Dr. Parikh, though, is not convinced that the third change, relegation of the doctor-patient relationship, is a benefit:

"It’s hard to quantify, but trust and familiarity between a patient and her physician, someone who knows her and her health problems, is one of the greatest efficiencies in health care. There’s less time and effort getting to know all the nitty-gritty details of that patient’s health history and more time to focus on the problem at hand. And patients leave with a greater sense of confidence with the outcomes of the visit based in the relationship, not the technology."

Is this assessment correct?

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