Computer-Mediated Communication in Medical Consultation: A Case Study of Doctorgeorge.com

Abstract

In the early stages of human medical history, physical and psychological disorders were treated through quasi-religious rites rather than through scientifically based procedures. The application of the scientific method to problems of human health and illnesses began at the time of ancient Greek physician Hippocrates, around the 5th century BC. By the 21" century, medicine, the treatment of human illnesses and disease, has advanced so dramatically with the rapid development in information in the medical sciences. Central to the practice and successful pursuit of medicine is communication with a stress on communication with the patient. Communication is used for the purposes of diagnosis, cooperation, counseling, education, and a more recent view of it having a direct impact on the recovery of patients. The primary form in the doctor-patient communication relationship is the medical consultation wherein a patient seeks the professional advice and opinion of a doctor for recourse and instruction regarding his health or medical condition. Effective communication during the medical consultation is of utmost importance, since the doctor's competent diagnosis and the patient's eventual compliance is based upon it. There are three factors affecting effective doctor-patient communication namely: patient related (physical symptoms of the illness, psychological factors such as anxiety and denial, previous and current experience in medical care); doctor related (training in communication skills, self-confidence in ability to communicate, personality, physical factors such as tiredness, and psychological factors such as anxiety); and interview setting requirements (comfortable surroundings, and an appropriate seating arrangement). Traditionally, medical consultations have been face-to-face interactions. In this age of the development of the computer, communication technology, and the Internet, society is faced with medical consultation using computer-mediated communication, otherwise known as on-line medical consultation. Computer mediated communication is defined as any communication wherein a computer or network of computers is used as a means or medium of communication. The most often used types of on-line medical consultation is via e-mail and via chat; both text-based forms of computer mediated communication. On-line medical consultation can either be through the patient's personal doctor or through on-line doctors from e-medicine websites that offer on-line medical consultation. Only one Philippine based e-medicine website offers on-line medical consultation via chat and this is DoctorGeorge.com. The newness of the technology and the phenomena, particularly in the Philippine setting, makes one cast doubt upon the effectiveness of DoctorGeorge.com to provide medical consultation via on-line chat to Filipino patients. Thus, the author posed the main problem, "ls DoctorGeorge.com an effective medium for medical consultation as perceived by its patients?" The subproblems were: "What is the nature of DoctorGeorge.com and its services?"; "What is the profile of the Filipino patients of DoctorGeorge.com?"; "What is the profile of the Filipino doctors of DoctorGeorge.com?"; "How often do patients consult DoctorGeorge.com?"; and "What are the perceived advantages/disadvantages of computer mediated communication (DoctorGeorge.com) in medical consultation?" The study's general objective was to determine whether or not DoctorGeorge.com is an effective medium for medical consultation. Also known as the clinical interview, medical consultation has traditionally been in the form of face-to-face interpersonal communication. Being the primary form of doctor-patient communication, medical consultation is the original basis of all other steps in curing a patient. Society is now faced with a very novel situation where computer mediated communication through the Internet is fast becoming a part of their daily lives and on-line 'everything' is daily fare. This situation gives scholars an unlimited area of study for communication. This study focused on the use of computer mediated communication in medical consultation via on-line chat, more conveniently referred to as on-line medical consultation, as offered by DoctorGeorge.com. This study will try to discover a deeper understanding in this new field of on-line medical consultation, the profile of the people who participate in it, as well as their experience with it. Its key informants were exclusively Filipino patients of DoctorGeorge.com and only those patients who have consulted on-line via DoctorGeorge.com's medical chatroom. As far as the researcher knows, this is the first time that a study which focuses on the Filipinos' use of computer mediated communication in medical consultation was undertaken. In this situation where there is a dearth in information regarding this novel phenomenon in the Philippine setting, an exploratory descriptive approach was taken. Now that there is a limited number of Filipinos who use on-line medical consultation via the medical chatroom of DoctorGeorge.com, a non-probability convenience sampling procedure was used. Primarily, the data was gathered through a survey questionnaire sent via e-mail, to facilitate questions regarding the respondents' profile and their experience with DoctorGeorge.com. It was found that DoctoGeorge.com is a California established, Philippine based e-medicine website, which among other things, offers on-line medical consultation via chat and e-mail 24-hours a day. Filipino patients are mostly college educated, computer and Internet proficient, relatively well-to-do adults. Majority of them are comfortable and satisfied in consulting via DoctorGeorge.com's medical chatroom and would recommend the service to their friends and acquaintances. Majority of the doctors are young, well schooled (majority of whom are UP College of Medicine graduates), and Internet proficient individuals. The competency of the doctors in providing on-line medical advice is guaranteed through a stringent recruitment, qualification and training process. Most of the Filipino patients have consulted one to four (1-4) times, while an average of20 Filipino patients a day consult through the medical chatroom. The perceived advantages of on-line medical consultation via DoctorGeorge.com are convenience, practicality, being free, immediacy, anonymity, privacy, informativeness, detailness comprehensiveness, comfortability, reliability, being a good source of second opinion, good for emergency purposes, and more patients having more time for questions. The perceived disadvantages are that there are no actual physical check-ups, no face-to-face encounter, no real diagnosis, no medical tests, no prescription, and unknown doctor's credentials, coupled with technical difficulties, the possibility of miscommunication, doubts in reliability and accuracy, being generalized in nature, being too careful in giving advice, being time consuming, time limitations, and inappropriateness for difficult cases.