Saturday, 11 October 2014

The informed patient

Every now and then we hear about people who look up their medical condition on the web and even tell the doctor what needs to be done. 

However, GPs could be said to mediate between patients and their own bodies and they certainly mediate between patients and the wider health machine. So patients who research their illness beforehand are trying to shortcut or at least understand part of the doctor’s mediation service. Presumably doctors don’t approve.

With the growth in information technology, this trend can be no great surprise to anyone including the medical profession, but what does it imply? If we look at the role of mediation in service industries then it could imply something of wider significance than healthcare.

As with doctors, the status of a mediator and the service they offer is often backed a certain mystique which also tends to be based on arcane knowledge. 

In times gone by this kind of mediation was almost entirely in the hands of the established church via its priests and high officials. Established churches offered the ultimate mediation service – mediation between the faithful and God - a very ancient form of social control.

A decline in religious observance seems to have coincided with a rise of a whole plethora of alternative mediation services still based, at least in part, on mystique and arcane knowledge. We call them service industries but the parallel with priestly mediation is striking. Potentially just as fragile too - in the face of information technology and the simple human desire to know.

So when patients arm themselves with knowledge before consulting their doctor, maybe we are seeing a fracture in the mystique of arcane knowledge. It’s not that the doctor has little to offer, but more interestingly, a possible crumbling of the doctor’s mystique and a recognition that his or her knowledge is accessible and not arcane.

The issue is complex because this is a subtle social and technological shift rather than a quantifiable economic trend. Even so it could have a profoundly negative impact on any service industry where the price and/or demand for mediation are sustained by an element of mystique and arcane knowledge.

Bankers we already know about, but how much of their trouble was caused by their inability or unwillingness to mediate between their customers and financial complexities? How much of an improvement would follow from a drastic simplification and demystifying of what bankers do? Has the mystique disappeared anyway?

Lawyers mediate between their clients and the law. On the surface there is nothing wrong with that, but what about the element of mystique and arcane knowledge which always seem to go with mediation?

To take an example from the entertainment industry, BrianCox offers mediation between TV viewers and the whole universe. Some folk don’t do things by halves do they? Lots of mystique and arcane knowledge behind that one.

Psychologists and psychiatrists offer mediation between a client and their own mind. Surely an example of professional chutzpah worth savouring.

Politicians offer mediation between voters and the hazards of the real world. Their credibility is crumbling to dust mostly because of their inability to mediate as claimed. 

However, their political failures could be the harbinger of wider failures. The failure of politicians to mediate as claimed, their obvious lack of arcane knowledge and the tarnished mystique of power may have implications well beyond politics.


Demetrius said...

Essentially, it is about information, often basic, sometimes complicated. In the old days you got the info' from the professionals. To do it on your own meant hours in a good reference library. What is the grey area is interpretation. Now, a fairly capable computer user who is literate and able to think a bit can pull up vast amounts of information as and when they want and often in readable form with explanation etc. In the last few days I have become very informed about the Madras Native Infantry in the period of The Raj. If I can do this in minutes then I can do legal, medical and other stuff.

James Higham said...

The doctor I'd trust would prescribe whisky and a brisk walk in the morning.

A K Haart said...

Demetrius - yes and it makes a difference, how much of a difference I don't think we've worked out yet, but it could be enormous.

James - both before breakfast?